{"id":{"repo_id":"pretoria","oai_identifier":"oai:repository.up.ac.za:2263/61672"},"canonical_url":"https://search.dev.ndltd.org/etd/pretoria/oai:repository.up.ac.za:2263/61672","repository":{"repo_id":"pretoria","name":"University of Pretoria","base_url":"https://repository.up.ac.za/server/oai/request"},"display":{"title":"A wellness programme to prevent and manage compassion fatigue amongst nurses working in an anti-retroviral clinic in a public tertiary hospital","abstract":"English: Introduction: Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped and affects those who work in caring professions. Helping people in distress can traumatise the helper because of their empathetic ability. Nurses who work in ARV clinics witness the suffering of their patients when they listen to their patients' descriptions of the trauma that they have to cope with. The patients get the chance to let go of the trauma and to share their concerns. Unfortunately the nurses often absorb some of the emotional pain of their patients and not all nurses are equipped to handle the situations in such a way that they do not become secondarily affected by the trauma of their patients and therefore, become vulnerable to develop compassion fatigue. If compassion fatigue is not identified in time and addressed adequately, the affected nurses may develop feelings of hopelessness in their ability to take care of their patients with detrimental effect on the quality of nursing care to these patients. Aims: Firstly, to explore and describe the extent of the manifestation of compassion fatigue amongst nurses working in antiretroviral clinics; and secondly, to develop a wellness programme to aid in the identification and management of episodes of compassion fatigue as well as the prevention of future occurrences of such episodes of compassion fatigue amongst nurses working in antiretroviral clinics. Methodology: The researcher conducted the study in two phases. In Phase one, a single embedded case study design, with three sub-units situated within the case, namely nurses who work in the adult, ante-natal and paediatric ARV clinics in a tertiary public hospital, was used. Purposive sampling was used to select seven nurses. Data was collected using semi-structured interviews. The researcher used content analysis as described by Elo and Kyngäs (2008) to analyse the transcribed interviews. The themes identified include the risk to develop compassion fatigue, manifestation of compassion fatigue and strategies to prevent and manage compassion fatigue. For document analysis the researcher used professional and enrolled nurses' job description and the employee health and wellness programme for public service. In Phase two, the researcher developed the wellness programme to aid in the identification, prevention and management of compassion fatigue amongst nurses who work in antiretroviral clinics and the Delphi Method was used to refine the wellness programme. Findings: Nurses working in the ARV clinics are at risk of developing compassion fatigue due to work environment issues such as challenges created by the health care system, lack of support from management, and their overwhelming work load. The cost of the nurse-patient relationship also contributed to nurses being at risk of compassion fatigue. Aspects that were identified that relate to the cost of a relationship with patients who are HIV positive include caring for traumatised patients, vicarious exposure to traumatic experiences of patients, and the influence caring for patients who are HIV positive has had on nurses' personal lives and their families. Nurses can traumatise their family members by continually not being available for them through emotional withdrawal. Nurses presented with physical, psychological, spiritual symptoms and changes in their behaviour that are indicative of compassion fatigue. Various strategies to prevent and manage compassion fatigue were identified: both what nurses can do, and what they expected from management. Nurses' job description is generic and does not spell out their role and function within antiretroviral clinics. The implementation of the health and wellness programme is lacking. The findings of Phase one and related literatures formed the bases from which the researcher developed the wellness programme to aid with the identification, prevention and management of compassion fatigue. Conclusion: Nurses are at risk of developing compassion fatigue due to the cost of the nurse-patient relationship with patients who are HIV positive. The key to prevention of compassion fatigue is awareness and a number of strategies that can aid in the identification, prevention and management of compassion fatigue have been identified and included in the wellness programme. Managerial support and practicing of self-care is important to maintain the health and well-being of nurses who work in antiretroviral clinic. Sepedi: Matseno: Molapo ka kwelobohloko ke boemo bjo bo feteletšego bja kgatelelo le go swarega ka tlaišego ya bao ba thušwago gomme bo ama bao ba šomago diprofešeneng tša tlhokomelo. Go thuša batho bao ba lego tlalelong go ka kweša mothuši bohloko ka lebaka la bokgoni bja bona bja kwelobohloko. Baoki bao ba šomago dikliniking tša ARV ba hlatsela tlaišego ya balwetši ba bona ge ba theeletša ditlhalošo tša balwetši ba bona ka lešoko leo ba swanetšego go šogana le lona. Balwetši ba hwetša sebaka sa go tlogela lešoko le go abelana dipelaelo tša bona. Ka bomadimabe baoki gantši ba angwa ke maikutlo bja balwetši ba bona gomme ga se baoki ka moka bao ba hlometšwego go swaragana le maemo ka tsela yeo ba sa amegego ka tsela ya bobedi ke masetlapelo a balwetši ba bona gomme ka fao, ba ba kotsing ya go kgotlelela molapo wa kwelobohloko. Ge e ba go lapa ga kwelobohloko go sa lemogwe ka nako gomme gwa rarollwa ka mo go lekanego, baoki bao ba amilwego ba ka ba le maikutlo a go hloka kholofelo bokgoning bja bona bja go hlokomela balwetši ba bona ka mafelelo a kotsi boleng bja tlhokomelo ya booki go balwetši ba. Dinepo: Sa mathomo, go hlohlomiša le go hlaloša bogolo bja ponagatšo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale; le sa bobedi, go hlama lenaneo la bophelo bjo kaone go thuša go šupa le go laola ditiragalo tša molapo ka kwelobohloko gammogo le thibelo ya ditiragalo tša ka moso tša ditiragalo tše bjalo tša molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale. Mokgwa: Monyakišiši o dirile dinyakišišo tše ka dikgato tše pedi. Mo Kgatong ya pele, go šomišitšwe tlhamo e tee ya nyakišišo ya mohlala ye e tsentšwego, yeo e nago le diyuniti tše tharo tše nnyane tšeo di lego ka gare ga molato, e lego baoki bao ba šomago ka dikliniking tša ARV tša batho ba bagolo, pele ga pelego le tša bana sepetleleng sa setšhaba sa maemo a godimo. Go ile gwa dirišwa go tšea mehlala ka morero go kgetha baoki ba šupago. Datha e kgobokeditšwe ka go šomiša dipoledišano tšeo di sego tša rulaganywa gabotse. Monyakišiši o šomišitše tshekatsheko ya diteng bjalo ka ge e hlalošitšwe ke Elo le Kyngas (2008) go sekaseka dipoledišano tšeo di ngwadilwego. Merero ye e lemogilwego e akaretša kotsi ya go hlabolla molapo ka kwelobohloko, ponagatšo ya molapo ka kwelobohloko le maano a go thibela le go laola molapo ka kwelobohloko. Bakeng sa tshekatsheko ya ditokumente monyakišiši o šomišitše tlhalošo ya mošomo ya baoki ba profešenale le bao ba ngwadišitšwego le lenaneo la maphelo le bophelo bjo kaone bja bašomi bakeng sa tirelo ya setšhaba. Mo Kgatong ya bobedi, monyakišiši o hlamile lenaneo la bophelo bjo bobotse go thuša go šupa, thibelo le taolo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale gomme Mokgwa wa Delphi o šomišitšwe go kaonafatša lenaneo la maphelo. Diphihlelelo: Baoki bao ba šomago ka dikliniking tša ARV ba kotsing ya go ba le molapo ka kwelobohloko ka lebaka la ditaba tša tikologo ya mošomo go swana le ditlhohlo tšeo di hlotšwego ke tshepedišo ya tlhokomelo ya maphelo, go hloka thekgo go tšwa go bolaodi, le mošomo wa bona wo montši. Ditshenyagalelo tša tswalano ya mooki le molwetši le tšona di bile le seabe go baoki go ba kotsing ya molapo ka kwelobohloko. Dikarolo tšeo di lemogilwego tšeo di amanago le ditshenyagalelo tša tswalano le balwetši bao ba nago le HIV di akaretša go hlokomela balwetši bao ba gatelegilego, go pepentšhwa ga legato diphihlelo tše di kwešago bohloko tša balwetši, le khuetšo yeo go hlokomela balwetši bao ba nago le HIV go bilego le yona maphelong a baoki ka noši le malapeng a bona. Baoki ba ka gatelela menagano ya ditho tša lapa la bona ka go se hwetšagale ka mo go tšwelago pele bakeng sa bona ka go ikgogela morago maikwelong. Baoki ba ile ba tšweletša dika tša mmele, tša monagano, tša moya le diphetogo boitshwarong bja bona tšeo di bontšhago go lapa ga kwelobohloko. Maano a go fapafapana a go thibela le go laola go lapa ga kwelobohloko a ile a lemogwa: bobedi seo baoki ba ka se dirago, le seo ba bego ba se letetše go tšwa go taolo. Tlhalošo ya mošomo ya baoki ke ya kakaretšo gomme ga e pelete tema ya bona le mošomo ka gare ga dikliniki tša anthiretherobaerale. Phethagatšo ya lenaneo la maphelo le bophelo bjo kaone e a hlaelela. Diphihlelelo tša Kgato ya pele le dingwalo tše di amanago le yona di bopile metheo yeo go tšwa go yona monyakišiši a hlamilego lenaneo la maphelo a kaone go thuša ka go hlaola, thibelo le taolo ya molapo ka kwelobohloko. Sephetho: Baoki ba kotsing ya go ba le go lapa ga kwelobohloko ka lebaka la ditshenyagalelo tša kamano ya mooki le molwetši le balwetši bao ba nago le HIV. Bohlokwa bja thibelo ya molapo ka kwelobohloko ke temošo gomme maano a mmalwa ao a ka thušago go laetša, thibelo le taolo ya molapo ka kwelobohloko a lemogilwe le go akaretšwa lenaneong la bophelo bjo kaone. Thekgo ya bolaodi le go itlwaetša go itlhokomela go bohlokwa go hlokomela maphelo le bophelo bjo kaone bja baoki bao ba šomago kliniking ya anthiretherobaerale. Afrikaans: Inleiding: Empatie-uitputting is ’n uiterste toestand van spanning en beheptheid met die lyding van diegene wat gehelp word, en beïnvloed diegene wat in sorgberoepe werk. Om mense in nood te help, kan die helper traumatiseer as gevolg van hul vermoë tot empatie. Verpleegkundiges wat in ARV-klinieke werk, sien hul pasiënte se lyding wanneer hulle luister hoe hul pasiënte die trauma beskryf waarmee hulle te doen het. Die pasiënte kry die geleentheid om die trauma te laat vaar en hul bekommernisse te deel. Ongelukkig absorbeer verpleegsters dikwels van die emosionele pyn van hul pasiënte, en nie alle verpleegsters het die vermoë om die situasies so te hanteer dat hulle nie sekondêr deur die trauma van hul pasiënte geraak word nie, wat hulle kwesbaar maak om empatie-uitputting te ontwikkel. Indien empatie-uitputting nie betyds geïdentifiseer en voldoende hanteer word nie, kan die geaffekteerde verpleegkundiges hopeloos begin voel oor hul vermoë om vir hul pasiënte te sorg, wat ’n nadelige uitwerking op die gehalte van verpleegsorg aan hierdie pasiënte het. Doelwitte: Eerstens, om die omvang en die voorkoms van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, te ondersoek en te beskryf; en tweedens, om ’n welstandsprogram te ontwikkel wat voorvalle van empatie-uitputting kan help identifiseer en bestuur, asook toekomstige voorvalle van empatie-uitputting help voorkom onder verpleegkundiges wat in antiretrovirale klinieke werk. Metodologie: Die navorser het die studie in twee fases uitgevoer. In Fase Een is ’n enkele ingebedde gevallestudie-ontwerp gebruik, met drie subeenhede binne die geval, naamlik verpleegkundiges wat in die volwasse, die voorgeboortelike en die pediatriese ARV-klinieke van ’n tersiêre openbare hospitaal werk. Doelgerigte steekproefneming is gebruik om sewe verpleegkundiges te kies. Data is by wyse van semi-gestruktureerde onderhoude ingesamel. Die navorser het inhoudsontleding soos beskryf deur Elo en Kyngas (2008) gebruik om die getranskribeerde onderhoude te ontleed. Die geïdentifiseerde temas behels die risiko om empatie-uitputting te ontwikkel, die voorkoms van empatie-uitputting, en strategieë om empatie-uitputting te voorkom en te bestuur. Vir dokumentontleding het die navorser die posbeskrywings van professionele en ingeskrewe verpleegkundiges, en die werknemergesondheid- en welstandsprogram vir openbare diens gebruik. In Fase Twee het die navorser die welstandsprogram ontwikkel om te help met die identifisering, voorkoming en bestuur van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, en die Delphi-metode gebruik om die welstandsprogram te verfyn. Bevindinge: Verpleegkundiges wat in die ARV-klinieke werk, loop die risiko om empatie-uitputting te ontwikkel as gevolg van werkomgewingskwessies soos uitdagings wat deur die gesondheidsorgstelsel geskep word, ’n gebrek aan ondersteuning deur die bestuur, en hul oorweldigende werklas. Die prys wat die verpleegster-pasiënt-verhouding eis, het ook tot die risiko van empatie-uitputting onder verpleegsters bygedra. Aspekte wat geïdentifiseer is as bydraend tot die prys van ’n verhouding met pasiënte wat MIV-positief is, sluit in die versorging van getraumatiseerde pasiënte, plaasvervangende blootstelling aan die traumatiese ervarings van pasiënte, en die invloed wat sorg aan pasiënte wat MIV-positief is op verpleegsters se persoonlike lewens en hul gesinne gehad het. Verpleegsters kan hul gesinslede traumatiseer deur voortdurend nie vir hulle beskikbaar te wees nie weens emosionele onttrekking. Verpleegkundiges het fisieke, sielkundige en geestelike simptome en gedragsveranderinge getoon, wat tekens van empatie-uitputting is. Verskeie strategieë om empatie-uitputting te voorkom en te bestuur, is geïdentifiseer: sowel wat verpleegkundiges kan doen as wat hulle van bestuur verwag. Verpleegkundiges se posbeskrywing is generies, en spel nie hul rol en funksie in antiretrovirale klinieke uit nie. Die gesondheids- en welstandsprogram word nie geïmplementeer nie. Die bevindinge van Fase Een en verwante literatuur het die basis gevorm waarop die navorser die welstandsprogram gebou het om te help met die identifisering, voorkoming en bestuur van empatie-uitputting. Gevolgtrekking: Verpleegkundiges loop die risiko om empatie-uitputting te ontwikkel as gevolg van die prys van die verpleegster-pasiënt-verhouding met pasiënte wat MIV-positief is. Die sleutel tot die voorkoming van empatie-uitputting is bewustheid, en ’n aantal strategieë wat kan help met die identifisering, voorkoming en bestuur van empatie-uitputting is geïdentifiseer en in die welstandsprogram opgeneem. Ondersteuning deur die bestuur, en die beoefening van selfsorg, is belangrik vir die handhawing van die gesondheid en welstand van verpleegkundiges wat in antiretrovirale klinieke werk. IsiZulu: Isingeniso: Ukukhathala ngokuphathelene nozwela kuyisimo esibi kakhulu sokucindezeleka nokukhathazeka ngokuhlupheka kwalabo abasizwayo futhi kuthinta labo abasebenza emisebenzini yokunakekela. Ukusiza abantu abasosizini kungamhlukumeza umsizi ngenxa yokuba kwakhe nozwela. Abahlengikazi abasebenza emitholampilo yama-ARV bayakubona ukuhlupheka kweziguli zabo lapho belalela izincazelo zeziguli zabo ngosizi okumelwe zibhekane nalo. Iziguli zithola ithuba lokudedela ukuhlukumezeka nokwabelana ngezinto ezikukhathazayo. Ngeshwa abahlengikazi bavame ukuthatha obunye ubuhlungu obungokomzwelo beziguli zabo futhi akubona bonke abahlengikazi abahlonyiselwe ukusingatha izimo ngendlela yokuthi bangathinteki okwesibili ekucindezelekeni kweziguli zabo futhi ngenxa yalokho, babe sengozini yokuba nokukhathala ngokuphathelene nozwela. Uma ukukhathala kozwela kungabonakali ngesikhathi futhi kusingathwa ngokwanele, abahlengikazi abathintekayo bangase babe nemizwa yokuphelelwa yithemba emandleni abo okunakekela iziguli zabo okunomthelela omubi ezingeni lokunakekelwa kwabahlengikazi kulezi ziguli. Izinhloso: Okokuqala, ukuhlola nokuchaza ubukhulu bokubonakaliswa kokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yezidambisigciwane; futhi okwesibili, ukusungula uhlelo lokuphila kahle lokusiza ekuhlonzeni nasekulawuleni iziqephu zokukhathala kozwela kanye nokuvimbela izehlakalo zesikhathi esizayo zeziqephu ezinjalo zokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo. Indlela yokwenza: Umcwaningi wenza ucwaningo ngezigaba ezimbili. Esigabeni sokuqala, kusetshenziswe umklamo owodwa wocwaningo, onamayunithi amancane amathathu akuleso simo, okungabahlengikazi abasebenza emitholampilo yabantu abadala, emitholampilo yemishanguzo yangaphambi kokubeletha neyezingane esibhedlela somphakathi esisezingeni eliphakeme. Ukuthatha isampula okuhlosiwe kwasetshenziselwa ukukhetha abahlengikazi abayisikhombisa. Idatha eyinhloko yaqoqwa kusetshenziswa izingxoxo ezihlelwe kancane. Umcwaningi wasebenzisa ukuhlaziywa kokuqukethwe njengoba kuchazwe u-Elo no-Kyngas (2008) ukuze ahlaziye izingxoxo ezibhaliwe eziseuselwa kokuqoshiwe. Izihloko ezihlonziwe zihlanganisa ubungozi bokuba nokukhathala ngokuphathelene nozwela, ukubonakaliswa kokukhathala ngokuphathelene nozwela namasu okuvimbela kanye nokwengammela ukukhathala ngokuphathelene nozwela. Ukuze kuhlaziywe amadokhumenti umcwaningi wasebenzisa incazelo yomsebenzi yo-enroled kanye no-professional nurse kanye nababhalisile kanye nohlelo lwezempilo nenhlalakahle yabasebenzela umphakathi. Esigabeni sesibili, umcwaningi wasungula uhlelo lwempilo ukuze asize ekuhlonzeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo kanye neye-Delphi Method yasetshenziselwa ukuthuthukisa uhlelo lokuphila kahle. Okutholakele: Abahlengikazi abasebenza emitholampilo yemishanguzo abasengozini yokuba nokukhathala ngenxa yezinkinga zendawo yokusebenza ezinjengezinselelo ezibangelwa uhlelo lokunakekelwa kwempilo, ukuntuleka kosizo oluvela kubaphathi, kanye nomsebenzi wabo omningi ngokweqile. Izindleko zobuhlobo bomhlengikazi nesiguli nazo zaba nomthelela ekutheni abahlengikazi babe sengozini yokukhathala ngokuphathelene nesihawu. Izici ezikhonjiwe ezihlobene nezindleko zobudlelwano neziguli ezineGciwane Lesandulela Ngculazi zihlanganisa ukunakekela iziguli ezihlukumezekile, ukuchayeka kokuhlangenwe nakho okubuhlungu ngokuphathelene neziguli, nethonya lokunakekela iziguli ezineGciwane Lesandulela Ngculazi kuye kwaba nalo ezimpilweni zomuntu uqobo zabahlengikazi nemindeni yabo. Abahlengikazi bangahlukumeza amalungu omndeni wabo ngokuqhubeka bengatholakali kubo ngenxa yokuhoxa ngokuphathele nomzwelo. Abahlengikazi bakhombise izimpawu ezingokomzimba, ezingokwengqondo, ezingokomoya kanye nezinguquko ekuziphatheni kwabo okubonisa ukukhathala ngokuphathelene nozwela. Kwaqashelwa amasu ahlukahlukene okuvimbela nokulawula ukukhathala ngokuphathelene nozwela: kokubili lokho abahlengikazi abangakwenza, nalokho ababekulindele kubaphathi. Incazelo yomsebenzi wabahlengikazi ijwayelekile futhi ayichazi indima yabo nokusebenza kwabo emitholampilo yemishanguzo. Kuyashoda ukuqaliswa kohlelo lwezempilo kanye nenhlalakahle. Okutholakele kweSigaba sokuqala sokubhaliwe okuhlobene nakho kwakha izisekelo lapho umcwaningi asungula khona uhlelo lokuphila kahle ukuze asize ekuhlonzeni, ekuvimbeleni kanye nasekwenganyelweni kokukhathala ngokuphathelene nozwela. Isiphetho: Abahlengikazi basengozini yokuba nokukhathala ngokuphathelene nozwela ngenxa yomthwalo wobudlelwano besiguli nomhlengikazi eziguli ezineGciwane Lesandulela Ngculazi. Isihluthulelo sokuvimbela ukukhathala kozwela ukuqwashisa futhi amasu amaningana angasiza ekukhombeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela asekhonjiwe futhi afakiwe ohlelweni lwezempilo. Ukusekelwa kwabaphathi kanye nokuzinakekela kubalulekile ukuze kulondolozwe impilo nenhlalakahle yabahlengikazi abasebenza emtholampilo wemishanguzo.","abstract_html":"English: Introduction: Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped and affects those who work in caring professions. Helping people in distress can traumatise the helper because of their empathetic ability. Nurses who work in ARV clinics witness the suffering of their patients when they listen to their patients' descriptions of the trauma that they have to cope with. The patients get the chance to let go of the trauma and to share their concerns. Unfortunately the nurses often absorb some of the emotional pain of their patients and not all nurses are equipped to handle the situations in such a way that they do not become secondarily affected by the trauma of their patients and therefore, become vulnerable to develop compassion fatigue. If compassion fatigue is not identified in time and addressed adequately, the affected nurses may develop feelings of hopelessness in their ability to take care of their patients with detrimental effect on the quality of nursing care to these patients. Aims: Firstly, to explore and describe the extent of the manifestation of compassion fatigue amongst nurses working in antiretroviral clinics; and secondly, to develop a wellness programme to aid in the identification and management of episodes of compassion fatigue as well as the prevention of future occurrences of such episodes of compassion fatigue amongst nurses working in antiretroviral clinics. Methodology: The researcher conducted the study in two phases. In Phase one, a single embedded case study design, with three sub-units situated within the case, namely nurses who work in the adult, ante-natal and paediatric ARV clinics in a tertiary public hospital, was used. Purposive sampling was used to select seven nurses. Data was collected using semi-structured interviews. The researcher used content analysis as described by Elo and Kyngäs (2008) to analyse the transcribed interviews. The themes identified include the risk to develop compassion fatigue, manifestation of compassion fatigue and strategies to prevent and manage compassion fatigue. For document analysis the researcher used professional and enrolled nurses' job description and the employee health and wellness programme for public service. In Phase two, the researcher developed the wellness programme to aid in the identification, prevention and management of compassion fatigue amongst nurses who work in antiretroviral clinics and the Delphi Method was used to refine the wellness programme. Findings: Nurses working in the ARV clinics are at risk of developing compassion fatigue due to work environment issues such as challenges created by the health care system, lack of support from management, and their overwhelming work load. The cost of the nurse-patient relationship also contributed to nurses being at risk of compassion fatigue. Aspects that were identified that relate to the cost of a relationship with patients who are HIV positive include caring for traumatised patients, vicarious exposure to traumatic experiences of patients, and the influence caring for patients who are HIV positive has had on nurses' personal lives and their families. Nurses can traumatise their family members by continually not being available for them through emotional withdrawal. Nurses presented with physical, psychological, spiritual symptoms and changes in their behaviour that are indicative of compassion fatigue. Various strategies to prevent and manage compassion fatigue were identified: both what nurses can do, and what they expected from management. Nurses' job description is generic and does not spell out their role and function within antiretroviral clinics. The implementation of the health and wellness programme is lacking. The findings of Phase one and related literatures formed the bases from which the researcher developed the wellness programme to aid with the identification, prevention and management of compassion fatigue. Conclusion: Nurses are at risk of developing compassion fatigue due to the cost of the nurse-patient relationship with patients who are HIV positive. The key to prevention of compassion fatigue is awareness and a number of strategies that can aid in the identification, prevention and management of compassion fatigue have been identified and included in the wellness programme. Managerial support and practicing of self-care is important to maintain the health and well-being of nurses who work in antiretroviral clinic. Sepedi: Matseno: Molapo ka kwelobohloko ke boemo bjo bo feteletšego bja kgatelelo le go swarega ka tlaišego ya bao ba thušwago gomme bo ama bao ba šomago diprofešeneng tša tlhokomelo. Go thuša batho bao ba lego tlalelong go ka kweša mothuši bohloko ka lebaka la bokgoni bja bona bja kwelobohloko. Baoki bao ba šomago dikliniking tša ARV ba hlatsela tlaišego ya balwetši ba bona ge ba theeletša ditlhalošo tša balwetši ba bona ka lešoko leo ba swanetšego go šogana le lona. Balwetši ba hwetša sebaka sa go tlogela lešoko le go abelana dipelaelo tša bona. Ka bomadimabe baoki gantši ba angwa ke maikutlo bja balwetši ba bona gomme ga se baoki ka moka bao ba hlometšwego go swaragana le maemo ka tsela yeo ba sa amegego ka tsela ya bobedi ke masetlapelo a balwetši ba bona gomme ka fao, ba ba kotsing ya go kgotlelela molapo wa kwelobohloko. Ge e ba go lapa ga kwelobohloko go sa lemogwe ka nako gomme gwa rarollwa ka mo go lekanego, baoki bao ba amilwego ba ka ba le maikutlo a go hloka kholofelo bokgoning bja bona bja go hlokomela balwetši ba bona ka mafelelo a kotsi boleng bja tlhokomelo ya booki go balwetši ba. Dinepo: Sa mathomo, go hlohlomiša le go hlaloša bogolo bja ponagatšo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale; le sa bobedi, go hlama lenaneo la bophelo bjo kaone go thuša go šupa le go laola ditiragalo tša molapo ka kwelobohloko gammogo le thibelo ya ditiragalo tša ka moso tša ditiragalo tše bjalo tša molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale. Mokgwa: Monyakišiši o dirile dinyakišišo tše ka dikgato tše pedi. Mo Kgatong ya pele, go šomišitšwe tlhamo e tee ya nyakišišo ya mohlala ye e tsentšwego, yeo e nago le diyuniti tše tharo tše nnyane tšeo di lego ka gare ga molato, e lego baoki bao ba šomago ka dikliniking tša ARV tša batho ba bagolo, pele ga pelego le tša bana sepetleleng sa setšhaba sa maemo a godimo. Go ile gwa dirišwa go tšea mehlala ka morero go kgetha baoki ba šupago. Datha e kgobokeditšwe ka go šomiša dipoledišano tšeo di sego tša rulaganywa gabotse. Monyakišiši o šomišitše tshekatsheko ya diteng bjalo ka ge e hlalošitšwe ke Elo le Kyngas (2008) go sekaseka dipoledišano tšeo di ngwadilwego. Merero ye e lemogilwego e akaretša kotsi ya go hlabolla molapo ka kwelobohloko, ponagatšo ya molapo ka kwelobohloko le maano a go thibela le go laola molapo ka kwelobohloko. Bakeng sa tshekatsheko ya ditokumente monyakišiši o šomišitše tlhalošo ya mošomo ya baoki ba profešenale le bao ba ngwadišitšwego le lenaneo la maphelo le bophelo bjo kaone bja bašomi bakeng sa tirelo ya setšhaba. Mo Kgatong ya bobedi, monyakišiši o hlamile lenaneo la bophelo bjo bobotse go thuša go šupa, thibelo le taolo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale gomme Mokgwa wa Delphi o šomišitšwe go kaonafatša lenaneo la maphelo. Diphihlelelo: Baoki bao ba šomago ka dikliniking tša ARV ba kotsing ya go ba le molapo ka kwelobohloko ka lebaka la ditaba tša tikologo ya mošomo go swana le ditlhohlo tšeo di hlotšwego ke tshepedišo ya tlhokomelo ya maphelo, go hloka thekgo go tšwa go bolaodi, le mošomo wa bona wo montši. Ditshenyagalelo tša tswalano ya mooki le molwetši le tšona di bile le seabe go baoki go ba kotsing ya molapo ka kwelobohloko. Dikarolo tšeo di lemogilwego tšeo di amanago le ditshenyagalelo tša tswalano le balwetši bao ba nago le HIV di akaretša go hlokomela balwetši bao ba gatelegilego, go pepentšhwa ga legato diphihlelo tše di kwešago bohloko tša balwetši, le khuetšo yeo go hlokomela balwetši bao ba nago le HIV go bilego le yona maphelong a baoki ka noši le malapeng a bona. Baoki ba ka gatelela menagano ya ditho tša lapa la bona ka go se hwetšagale ka mo go tšwelago pele bakeng sa bona ka go ikgogela morago maikwelong. Baoki ba ile ba tšweletša dika tša mmele, tša monagano, tša moya le diphetogo boitshwarong bja bona tšeo di bontšhago go lapa ga kwelobohloko. Maano a go fapafapana a go thibela le go laola go lapa ga kwelobohloko a ile a lemogwa: bobedi seo baoki ba ka se dirago, le seo ba bego ba se letetše go tšwa go taolo. Tlhalošo ya mošomo ya baoki ke ya kakaretšo gomme ga e pelete tema ya bona le mošomo ka gare ga dikliniki tša anthiretherobaerale. Phethagatšo ya lenaneo la maphelo le bophelo bjo kaone e a hlaelela. Diphihlelelo tša Kgato ya pele le dingwalo tše di amanago le yona di bopile metheo yeo go tšwa go yona monyakišiši a hlamilego lenaneo la maphelo a kaone go thuša ka go hlaola, thibelo le taolo ya molapo ka kwelobohloko. Sephetho: Baoki ba kotsing ya go ba le go lapa ga kwelobohloko ka lebaka la ditshenyagalelo tša kamano ya mooki le molwetši le balwetši bao ba nago le HIV. Bohlokwa bja thibelo ya molapo ka kwelobohloko ke temošo gomme maano a mmalwa ao a ka thušago go laetša, thibelo le taolo ya molapo ka kwelobohloko a lemogilwe le go akaretšwa lenaneong la bophelo bjo kaone. Thekgo ya bolaodi le go itlwaetša go itlhokomela go bohlokwa go hlokomela maphelo le bophelo bjo kaone bja baoki bao ba šomago kliniking ya anthiretherobaerale. Afrikaans: Inleiding: Empatie-uitputting is ’n uiterste toestand van spanning en beheptheid met die lyding van diegene wat gehelp word, en beïnvloed diegene wat in sorgberoepe werk. Om mense in nood te help, kan die helper traumatiseer as gevolg van hul vermoë tot empatie. Verpleegkundiges wat in ARV-klinieke werk, sien hul pasiënte se lyding wanneer hulle luister hoe hul pasiënte die trauma beskryf waarmee hulle te doen het. Die pasiënte kry die geleentheid om die trauma te laat vaar en hul bekommernisse te deel. Ongelukkig absorbeer verpleegsters dikwels van die emosionele pyn van hul pasiënte, en nie alle verpleegsters het die vermoë om die situasies so te hanteer dat hulle nie sekondêr deur die trauma van hul pasiënte geraak word nie, wat hulle kwesbaar maak om empatie-uitputting te ontwikkel. Indien empatie-uitputting nie betyds geïdentifiseer en voldoende hanteer word nie, kan die geaffekteerde verpleegkundiges hopeloos begin voel oor hul vermoë om vir hul pasiënte te sorg, wat ’n nadelige uitwerking op die gehalte van verpleegsorg aan hierdie pasiënte het. Doelwitte: Eerstens, om die omvang en die voorkoms van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, te ondersoek en te beskryf; en tweedens, om ’n welstandsprogram te ontwikkel wat voorvalle van empatie-uitputting kan help identifiseer en bestuur, asook toekomstige voorvalle van empatie-uitputting help voorkom onder verpleegkundiges wat in antiretrovirale klinieke werk. Metodologie: Die navorser het die studie in twee fases uitgevoer. In Fase Een is ’n enkele ingebedde gevallestudie-ontwerp gebruik, met drie subeenhede binne die geval, naamlik verpleegkundiges wat in die volwasse, die voorgeboortelike en die pediatriese ARV-klinieke van ’n tersiêre openbare hospitaal werk. Doelgerigte steekproefneming is gebruik om sewe verpleegkundiges te kies. Data is by wyse van semi-gestruktureerde onderhoude ingesamel. Die navorser het inhoudsontleding soos beskryf deur Elo en Kyngas (2008) gebruik om die getranskribeerde onderhoude te ontleed. Die geïdentifiseerde temas behels die risiko om empatie-uitputting te ontwikkel, die voorkoms van empatie-uitputting, en strategieë om empatie-uitputting te voorkom en te bestuur. Vir dokumentontleding het die navorser die posbeskrywings van professionele en ingeskrewe verpleegkundiges, en die werknemergesondheid- en welstandsprogram vir openbare diens gebruik. In Fase Twee het die navorser die welstandsprogram ontwikkel om te help met die identifisering, voorkoming en bestuur van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, en die Delphi-metode gebruik om die welstandsprogram te verfyn. Bevindinge: Verpleegkundiges wat in die ARV-klinieke werk, loop die risiko om empatie-uitputting te ontwikkel as gevolg van werkomgewingskwessies soos uitdagings wat deur die gesondheidsorgstelsel geskep word, ’n gebrek aan ondersteuning deur die bestuur, en hul oorweldigende werklas. Die prys wat die verpleegster-pasiënt-verhouding eis, het ook tot die risiko van empatie-uitputting onder verpleegsters bygedra. Aspekte wat geïdentifiseer is as bydraend tot die prys van ’n verhouding met pasiënte wat MIV-positief is, sluit in die versorging van getraumatiseerde pasiënte, plaasvervangende blootstelling aan die traumatiese ervarings van pasiënte, en die invloed wat sorg aan pasiënte wat MIV-positief is op verpleegsters se persoonlike lewens en hul gesinne gehad het. Verpleegsters kan hul gesinslede traumatiseer deur voortdurend nie vir hulle beskikbaar te wees nie weens emosionele onttrekking. Verpleegkundiges het fisieke, sielkundige en geestelike simptome en gedragsveranderinge getoon, wat tekens van empatie-uitputting is. Verskeie strategieë om empatie-uitputting te voorkom en te bestuur, is geïdentifiseer: sowel wat verpleegkundiges kan doen as wat hulle van bestuur verwag. Verpleegkundiges se posbeskrywing is generies, en spel nie hul rol en funksie in antiretrovirale klinieke uit nie. Die gesondheids- en welstandsprogram word nie geïmplementeer nie. Die bevindinge van Fase Een en verwante literatuur het die basis gevorm waarop die navorser die welstandsprogram gebou het om te help met die identifisering, voorkoming en bestuur van empatie-uitputting. Gevolgtrekking: Verpleegkundiges loop die risiko om empatie-uitputting te ontwikkel as gevolg van die prys van die verpleegster-pasiënt-verhouding met pasiënte wat MIV-positief is. Die sleutel tot die voorkoming van empatie-uitputting is bewustheid, en ’n aantal strategieë wat kan help met die identifisering, voorkoming en bestuur van empatie-uitputting is geïdentifiseer en in die welstandsprogram opgeneem. Ondersteuning deur die bestuur, en die beoefening van selfsorg, is belangrik vir die handhawing van die gesondheid en welstand van verpleegkundiges wat in antiretrovirale klinieke werk. IsiZulu: Isingeniso: Ukukhathala ngokuphathelene nozwela kuyisimo esibi kakhulu sokucindezeleka nokukhathazeka ngokuhlupheka kwalabo abasizwayo futhi kuthinta labo abasebenza emisebenzini yokunakekela. Ukusiza abantu abasosizini kungamhlukumeza umsizi ngenxa yokuba kwakhe nozwela. Abahlengikazi abasebenza emitholampilo yama-ARV bayakubona ukuhlupheka kweziguli zabo lapho belalela izincazelo zeziguli zabo ngosizi okumelwe zibhekane nalo. Iziguli zithola ithuba lokudedela ukuhlukumezeka nokwabelana ngezinto ezikukhathazayo. Ngeshwa abahlengikazi bavame ukuthatha obunye ubuhlungu obungokomzwelo beziguli zabo futhi akubona bonke abahlengikazi abahlonyiselwe ukusingatha izimo ngendlela yokuthi bangathinteki okwesibili ekucindezelekeni kweziguli zabo futhi ngenxa yalokho, babe sengozini yokuba nokukhathala ngokuphathelene nozwela. Uma ukukhathala kozwela kungabonakali ngesikhathi futhi kusingathwa ngokwanele, abahlengikazi abathintekayo bangase babe nemizwa yokuphelelwa yithemba emandleni abo okunakekela iziguli zabo okunomthelela omubi ezingeni lokunakekelwa kwabahlengikazi kulezi ziguli. Izinhloso: Okokuqala, ukuhlola nokuchaza ubukhulu bokubonakaliswa kokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yezidambisigciwane; futhi okwesibili, ukusungula uhlelo lokuphila kahle lokusiza ekuhlonzeni nasekulawuleni iziqephu zokukhathala kozwela kanye nokuvimbela izehlakalo zesikhathi esizayo zeziqephu ezinjalo zokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo. Indlela yokwenza: Umcwaningi wenza ucwaningo ngezigaba ezimbili. Esigabeni sokuqala, kusetshenziswe umklamo owodwa wocwaningo, onamayunithi amancane amathathu akuleso simo, okungabahlengikazi abasebenza emitholampilo yabantu abadala, emitholampilo yemishanguzo yangaphambi kokubeletha neyezingane esibhedlela somphakathi esisezingeni eliphakeme. Ukuthatha isampula okuhlosiwe kwasetshenziselwa ukukhetha abahlengikazi abayisikhombisa. Idatha eyinhloko yaqoqwa kusetshenziswa izingxoxo ezihlelwe kancane. Umcwaningi wasebenzisa ukuhlaziywa kokuqukethwe njengoba kuchazwe u-Elo no-Kyngas (2008) ukuze ahlaziye izingxoxo ezibhaliwe eziseuselwa kokuqoshiwe. Izihloko ezihlonziwe zihlanganisa ubungozi bokuba nokukhathala ngokuphathelene nozwela, ukubonakaliswa kokukhathala ngokuphathelene nozwela namasu okuvimbela kanye nokwengammela ukukhathala ngokuphathelene nozwela. Ukuze kuhlaziywe amadokhumenti umcwaningi wasebenzisa incazelo yomsebenzi yo-enroled kanye no-professional nurse kanye nababhalisile kanye nohlelo lwezempilo nenhlalakahle yabasebenzela umphakathi. Esigabeni sesibili, umcwaningi wasungula uhlelo lwempilo ukuze asize ekuhlonzeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo kanye neye-Delphi Method yasetshenziselwa ukuthuthukisa uhlelo lokuphila kahle. Okutholakele: Abahlengikazi abasebenza emitholampilo yemishanguzo abasengozini yokuba nokukhathala ngenxa yezinkinga zendawo yokusebenza ezinjengezinselelo ezibangelwa uhlelo lokunakekelwa kwempilo, ukuntuleka kosizo oluvela kubaphathi, kanye nomsebenzi wabo omningi ngokweqile. Izindleko zobuhlobo bomhlengikazi nesiguli nazo zaba nomthelela ekutheni abahlengikazi babe sengozini yokukhathala ngokuphathelene nesihawu. Izici ezikhonjiwe ezihlobene nezindleko zobudlelwano neziguli ezineGciwane Lesandulela Ngculazi zihlanganisa ukunakekela iziguli ezihlukumezekile, ukuchayeka kokuhlangenwe nakho okubuhlungu ngokuphathelene neziguli, nethonya lokunakekela iziguli ezineGciwane Lesandulela Ngculazi kuye kwaba nalo ezimpilweni zomuntu uqobo zabahlengikazi nemindeni yabo. Abahlengikazi bangahlukumeza amalungu omndeni wabo ngokuqhubeka bengatholakali kubo ngenxa yokuhoxa ngokuphathele nomzwelo. Abahlengikazi bakhombise izimpawu ezingokomzimba, ezingokwengqondo, ezingokomoya kanye nezinguquko ekuziphatheni kwabo okubonisa ukukhathala ngokuphathelene nozwela. Kwaqashelwa amasu ahlukahlukene okuvimbela nokulawula ukukhathala ngokuphathelene nozwela: kokubili lokho abahlengikazi abangakwenza, nalokho ababekulindele kubaphathi. Incazelo yomsebenzi wabahlengikazi ijwayelekile futhi ayichazi indima yabo nokusebenza kwabo emitholampilo yemishanguzo. Kuyashoda ukuqaliswa kohlelo lwezempilo kanye nenhlalakahle. Okutholakele kweSigaba sokuqala sokubhaliwe okuhlobene nakho kwakha izisekelo lapho umcwaningi asungula khona uhlelo lokuphila kahle ukuze asize ekuhlonzeni, ekuvimbeleni kanye nasekwenganyelweni kokukhathala ngokuphathelene nozwela. Isiphetho: Abahlengikazi basengozini yokuba nokukhathala ngokuphathelene nozwela ngenxa yomthwalo wobudlelwano besiguli nomhlengikazi eziguli ezineGciwane Lesandulela Ngculazi. Isihluthulelo sokuvimbela ukukhathala kozwela ukuqwashisa futhi amasu amaningana angasiza ekukhombeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela asekhonjiwe futhi afakiwe ohlelweni lwezempilo. Ukusekelwa kwabaphathi kanye nokuzinakekela kubalulekile ukuze kulondolozwe impilo nenhlalakahle yabahlengikazi abasebenza emtholampilo wemishanguzo.","abstract_has_math":false,"creators":[],"institution":"University of Pretoria","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Leech, Ronell"],"committee_chairs":[],"committee_members":[],"year":2016,"date_issued":"2016","date_published":"2016","updated_at":"2026-07-24T03:52:21Z","subjects":["UCTD","Compassion fatigue","HIV/AIDS","Wellness programmes","Delphi Method"],"languages":["en"],"rights":["© 2017 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria."],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["A2017"],"render_values":[{"text":"A2017","href":null,"code":true}]}]},"links":{"outbound_url":"http://hdl.handle.net/2263/61672","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Leech, Ronell"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2017-08-15T12:35:32Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2017-08-15T12:35:32Z"]},{"key":"dc:date.issued","label":"Date","values":["2016"]},{"key":"dc:publisher","label":"Institution","values":["University of Pretoria"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["UCTD","Compassion fatigue","HIV/AIDS","Wellness programmes","Delphi Method"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["© 2017 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["A2017"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/2263/61672"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Thesis (PhD)--University of Pretoria, 2016."]},{"key":"dc:description.abstract","label":"Abstract","values":["English: Introduction: Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped and affects those who work in caring professions. Helping people in distress can traumatise the helper because of their empathetic ability. Nurses who work in ARV clinics witness the suffering of their patients when they listen to their patients' descriptions of the trauma that they have to cope with. The patients get the chance to let go of the trauma and to share their concerns. Unfortunately the nurses often absorb some of the emotional pain of their patients and not all nurses are equipped to handle the situations in such a way that they do not become secondarily affected by the trauma of their patients and therefore, become vulnerable to develop compassion fatigue. If compassion fatigue is not identified in time and addressed adequately, the affected nurses may develop feelings of hopelessness in their ability to take care of their patients with detrimental effect on the quality of nursing care to these patients. Aims: Firstly, to explore and describe the extent of the manifestation of compassion fatigue amongst nurses working in antiretroviral clinics; and secondly, to develop a wellness programme to aid in the identification and management of episodes of compassion fatigue as well as the prevention of future occurrences of such episodes of compassion fatigue amongst nurses working in antiretroviral clinics. Methodology: The researcher conducted the study in two phases. In Phase one, a single embedded case study design, with three sub-units situated within the case, namely nurses who work in the adult, ante-natal and paediatric ARV clinics in a tertiary public hospital, was used. Purposive sampling was used to select seven nurses. Data was collected using semi-structured interviews. The researcher used content analysis as described by Elo and Kyngäs (2008) to analyse the transcribed interviews. The themes identified include the risk to develop compassion fatigue, manifestation of compassion fatigue and strategies to prevent and manage compassion fatigue. For document analysis the researcher used professional and enrolled nurses' job description and the employee health and wellness programme for public service. In Phase two, the researcher developed the wellness programme to aid in the identification, prevention and management of compassion fatigue amongst nurses who work in antiretroviral clinics and the Delphi Method was used to refine the wellness programme. Findings: Nurses working in the ARV clinics are at risk of developing compassion fatigue due to work environment issues such as challenges created by the health care system, lack of support from management, and their overwhelming work load. The cost of the nurse-patient relationship also contributed to nurses being at risk of compassion fatigue. Aspects that were identified that relate to the cost of a relationship with patients who are HIV positive include caring for traumatised patients, vicarious exposure to traumatic experiences of patients, and the influence caring for patients who are HIV positive has had on nurses' personal lives and their families. Nurses can traumatise their family members by continually not being available for them through emotional withdrawal. Nurses presented with physical, psychological, spiritual symptoms and changes in their behaviour that are indicative of compassion fatigue. Various strategies to prevent and manage compassion fatigue were identified: both what nurses can do, and what they expected from management. Nurses' job description is generic and does not spell out their role and function within antiretroviral clinics. The implementation of the health and wellness programme is lacking. The findings of Phase one and related literatures formed the bases from which the researcher developed the wellness programme to aid with the identification, prevention and management of compassion fatigue. Conclusion: Nurses are at risk of developing compassion fatigue due to the cost of the nurse-patient relationship with patients who are HIV positive. The key to prevention of compassion fatigue is awareness and a number of strategies that can aid in the identification, prevention and management of compassion fatigue have been identified and included in the wellness programme. Managerial support and practicing of self-care is important to maintain the health and well-being of nurses who work in antiretroviral clinic. Sepedi: Matseno: Molapo ka kwelobohloko ke boemo bjo bo feteletšego bja kgatelelo le go swarega ka tlaišego ya bao ba thušwago gomme bo ama bao ba šomago diprofešeneng tša tlhokomelo. Go thuša batho bao ba lego tlalelong go ka kweša mothuši bohloko ka lebaka la bokgoni bja bona bja kwelobohloko. Baoki bao ba šomago dikliniking tša ARV ba hlatsela tlaišego ya balwetši ba bona ge ba theeletša ditlhalošo tša balwetši ba bona ka lešoko leo ba swanetšego go šogana le lona. Balwetši ba hwetša sebaka sa go tlogela lešoko le go abelana dipelaelo tša bona. Ka bomadimabe baoki gantši ba angwa ke maikutlo bja balwetši ba bona gomme ga se baoki ka moka bao ba hlometšwego go swaragana le maemo ka tsela yeo ba sa amegego ka tsela ya bobedi ke masetlapelo a balwetši ba bona gomme ka fao, ba ba kotsing ya go kgotlelela molapo wa kwelobohloko. Ge e ba go lapa ga kwelobohloko go sa lemogwe ka nako gomme gwa rarollwa ka mo go lekanego, baoki bao ba amilwego ba ka ba le maikutlo a go hloka kholofelo bokgoning bja bona bja go hlokomela balwetši ba bona ka mafelelo a kotsi boleng bja tlhokomelo ya booki go balwetši ba. Dinepo: Sa mathomo, go hlohlomiša le go hlaloša bogolo bja ponagatšo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale; le sa bobedi, go hlama lenaneo la bophelo bjo kaone go thuša go šupa le go laola ditiragalo tša molapo ka kwelobohloko gammogo le thibelo ya ditiragalo tša ka moso tša ditiragalo tše bjalo tša molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale. Mokgwa: Monyakišiši o dirile dinyakišišo tše ka dikgato tše pedi. Mo Kgatong ya pele, go šomišitšwe tlhamo e tee ya nyakišišo ya mohlala ye e tsentšwego, yeo e nago le diyuniti tše tharo tše nnyane tšeo di lego ka gare ga molato, e lego baoki bao ba šomago ka dikliniking tša ARV tša batho ba bagolo, pele ga pelego le tša bana sepetleleng sa setšhaba sa maemo a godimo. Go ile gwa dirišwa go tšea mehlala ka morero go kgetha baoki ba šupago. Datha e kgobokeditšwe ka go šomiša dipoledišano tšeo di sego tša rulaganywa gabotse. Monyakišiši o šomišitše tshekatsheko ya diteng bjalo ka ge e hlalošitšwe ke Elo le Kyngas (2008) go sekaseka dipoledišano tšeo di ngwadilwego. Merero ye e lemogilwego e akaretša kotsi ya go hlabolla molapo ka kwelobohloko, ponagatšo ya molapo ka kwelobohloko le maano a go thibela le go laola molapo ka kwelobohloko. Bakeng sa tshekatsheko ya ditokumente monyakišiši o šomišitše tlhalošo ya mošomo ya baoki ba profešenale le bao ba ngwadišitšwego le lenaneo la maphelo le bophelo bjo kaone bja bašomi bakeng sa tirelo ya setšhaba. Mo Kgatong ya bobedi, monyakišiši o hlamile lenaneo la bophelo bjo bobotse go thuša go šupa, thibelo le taolo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale gomme Mokgwa wa Delphi o šomišitšwe go kaonafatša lenaneo la maphelo. Diphihlelelo: Baoki bao ba šomago ka dikliniking tša ARV ba kotsing ya go ba le molapo ka kwelobohloko ka lebaka la ditaba tša tikologo ya mošomo go swana le ditlhohlo tšeo di hlotšwego ke tshepedišo ya tlhokomelo ya maphelo, go hloka thekgo go tšwa go bolaodi, le mošomo wa bona wo montši. Ditshenyagalelo tša tswalano ya mooki le molwetši le tšona di bile le seabe go baoki go ba kotsing ya molapo ka kwelobohloko. Dikarolo tšeo di lemogilwego tšeo di amanago le ditshenyagalelo tša tswalano le balwetši bao ba nago le HIV di akaretša go hlokomela balwetši bao ba gatelegilego, go pepentšhwa ga legato diphihlelo tše di kwešago bohloko tša balwetši, le khuetšo yeo go hlokomela balwetši bao ba nago le HIV go bilego le yona maphelong a baoki ka noši le malapeng a bona. Baoki ba ka gatelela menagano ya ditho tša lapa la bona ka go se hwetšagale ka mo go tšwelago pele bakeng sa bona ka go ikgogela morago maikwelong. Baoki ba ile ba tšweletša dika tša mmele, tša monagano, tša moya le diphetogo boitshwarong bja bona tšeo di bontšhago go lapa ga kwelobohloko. Maano a go fapafapana a go thibela le go laola go lapa ga kwelobohloko a ile a lemogwa: bobedi seo baoki ba ka se dirago, le seo ba bego ba se letetše go tšwa go taolo. Tlhalošo ya mošomo ya baoki ke ya kakaretšo gomme ga e pelete tema ya bona le mošomo ka gare ga dikliniki tša anthiretherobaerale. Phethagatšo ya lenaneo la maphelo le bophelo bjo kaone e a hlaelela. Diphihlelelo tša Kgato ya pele le dingwalo tše di amanago le yona di bopile metheo yeo go tšwa go yona monyakišiši a hlamilego lenaneo la maphelo a kaone go thuša ka go hlaola, thibelo le taolo ya molapo ka kwelobohloko. Sephetho: Baoki ba kotsing ya go ba le go lapa ga kwelobohloko ka lebaka la ditshenyagalelo tša kamano ya mooki le molwetši le balwetši bao ba nago le HIV. Bohlokwa bja thibelo ya molapo ka kwelobohloko ke temošo gomme maano a mmalwa ao a ka thušago go laetša, thibelo le taolo ya molapo ka kwelobohloko a lemogilwe le go akaretšwa lenaneong la bophelo bjo kaone. Thekgo ya bolaodi le go itlwaetša go itlhokomela go bohlokwa go hlokomela maphelo le bophelo bjo kaone bja baoki bao ba šomago kliniking ya anthiretherobaerale. Afrikaans: Inleiding: Empatie-uitputting is ’n uiterste toestand van spanning en beheptheid met die lyding van diegene wat gehelp word, en beïnvloed diegene wat in sorgberoepe werk. Om mense in nood te help, kan die helper traumatiseer as gevolg van hul vermoë tot empatie. Verpleegkundiges wat in ARV-klinieke werk, sien hul pasiënte se lyding wanneer hulle luister hoe hul pasiënte die trauma beskryf waarmee hulle te doen het. Die pasiënte kry die geleentheid om die trauma te laat vaar en hul bekommernisse te deel. Ongelukkig absorbeer verpleegsters dikwels van die emosionele pyn van hul pasiënte, en nie alle verpleegsters het die vermoë om die situasies so te hanteer dat hulle nie sekondêr deur die trauma van hul pasiënte geraak word nie, wat hulle kwesbaar maak om empatie-uitputting te ontwikkel. Indien empatie-uitputting nie betyds geïdentifiseer en voldoende hanteer word nie, kan die geaffekteerde verpleegkundiges hopeloos begin voel oor hul vermoë om vir hul pasiënte te sorg, wat ’n nadelige uitwerking op die gehalte van verpleegsorg aan hierdie pasiënte het. Doelwitte: Eerstens, om die omvang en die voorkoms van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, te ondersoek en te beskryf; en tweedens, om ’n welstandsprogram te ontwikkel wat voorvalle van empatie-uitputting kan help identifiseer en bestuur, asook toekomstige voorvalle van empatie-uitputting help voorkom onder verpleegkundiges wat in antiretrovirale klinieke werk. Metodologie: Die navorser het die studie in twee fases uitgevoer. In Fase Een is ’n enkele ingebedde gevallestudie-ontwerp gebruik, met drie subeenhede binne die geval, naamlik verpleegkundiges wat in die volwasse, die voorgeboortelike en die pediatriese ARV-klinieke van ’n tersiêre openbare hospitaal werk. Doelgerigte steekproefneming is gebruik om sewe verpleegkundiges te kies. Data is by wyse van semi-gestruktureerde onderhoude ingesamel. Die navorser het inhoudsontleding soos beskryf deur Elo en Kyngas (2008) gebruik om die getranskribeerde onderhoude te ontleed. Die geïdentifiseerde temas behels die risiko om empatie-uitputting te ontwikkel, die voorkoms van empatie-uitputting, en strategieë om empatie-uitputting te voorkom en te bestuur. Vir dokumentontleding het die navorser die posbeskrywings van professionele en ingeskrewe verpleegkundiges, en die werknemergesondheid- en welstandsprogram vir openbare diens gebruik. In Fase Twee het die navorser die welstandsprogram ontwikkel om te help met die identifisering, voorkoming en bestuur van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, en die Delphi-metode gebruik om die welstandsprogram te verfyn. Bevindinge: Verpleegkundiges wat in die ARV-klinieke werk, loop die risiko om empatie-uitputting te ontwikkel as gevolg van werkomgewingskwessies soos uitdagings wat deur die gesondheidsorgstelsel geskep word, ’n gebrek aan ondersteuning deur die bestuur, en hul oorweldigende werklas. Die prys wat die verpleegster-pasiënt-verhouding eis, het ook tot die risiko van empatie-uitputting onder verpleegsters bygedra. Aspekte wat geïdentifiseer is as bydraend tot die prys van ’n verhouding met pasiënte wat MIV-positief is, sluit in die versorging van getraumatiseerde pasiënte, plaasvervangende blootstelling aan die traumatiese ervarings van pasiënte, en die invloed wat sorg aan pasiënte wat MIV-positief is op verpleegsters se persoonlike lewens en hul gesinne gehad het. Verpleegsters kan hul gesinslede traumatiseer deur voortdurend nie vir hulle beskikbaar te wees nie weens emosionele onttrekking. Verpleegkundiges het fisieke, sielkundige en geestelike simptome en gedragsveranderinge getoon, wat tekens van empatie-uitputting is. Verskeie strategieë om empatie-uitputting te voorkom en te bestuur, is geïdentifiseer: sowel wat verpleegkundiges kan doen as wat hulle van bestuur verwag. Verpleegkundiges se posbeskrywing is generies, en spel nie hul rol en funksie in antiretrovirale klinieke uit nie. Die gesondheids- en welstandsprogram word nie geïmplementeer nie. Die bevindinge van Fase Een en verwante literatuur het die basis gevorm waarop die navorser die welstandsprogram gebou het om te help met die identifisering, voorkoming en bestuur van empatie-uitputting. Gevolgtrekking: Verpleegkundiges loop die risiko om empatie-uitputting te ontwikkel as gevolg van die prys van die verpleegster-pasiënt-verhouding met pasiënte wat MIV-positief is. Die sleutel tot die voorkoming van empatie-uitputting is bewustheid, en ’n aantal strategieë wat kan help met die identifisering, voorkoming en bestuur van empatie-uitputting is geïdentifiseer en in die welstandsprogram opgeneem. Ondersteuning deur die bestuur, en die beoefening van selfsorg, is belangrik vir die handhawing van die gesondheid en welstand van verpleegkundiges wat in antiretrovirale klinieke werk. IsiZulu: Isingeniso: Ukukhathala ngokuphathelene nozwela kuyisimo esibi kakhulu sokucindezeleka nokukhathazeka ngokuhlupheka kwalabo abasizwayo futhi kuthinta labo abasebenza emisebenzini yokunakekela. Ukusiza abantu abasosizini kungamhlukumeza umsizi ngenxa yokuba kwakhe nozwela. Abahlengikazi abasebenza emitholampilo yama-ARV bayakubona ukuhlupheka kweziguli zabo lapho belalela izincazelo zeziguli zabo ngosizi okumelwe zibhekane nalo. Iziguli zithola ithuba lokudedela ukuhlukumezeka nokwabelana ngezinto ezikukhathazayo. Ngeshwa abahlengikazi bavame ukuthatha obunye ubuhlungu obungokomzwelo beziguli zabo futhi akubona bonke abahlengikazi abahlonyiselwe ukusingatha izimo ngendlela yokuthi bangathinteki okwesibili ekucindezelekeni kweziguli zabo futhi ngenxa yalokho, babe sengozini yokuba nokukhathala ngokuphathelene nozwela. Uma ukukhathala kozwela kungabonakali ngesikhathi futhi kusingathwa ngokwanele, abahlengikazi abathintekayo bangase babe nemizwa yokuphelelwa yithemba emandleni abo okunakekela iziguli zabo okunomthelela omubi ezingeni lokunakekelwa kwabahlengikazi kulezi ziguli. Izinhloso: Okokuqala, ukuhlola nokuchaza ubukhulu bokubonakaliswa kokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yezidambisigciwane; futhi okwesibili, ukusungula uhlelo lokuphila kahle lokusiza ekuhlonzeni nasekulawuleni iziqephu zokukhathala kozwela kanye nokuvimbela izehlakalo zesikhathi esizayo zeziqephu ezinjalo zokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo. Indlela yokwenza: Umcwaningi wenza ucwaningo ngezigaba ezimbili. Esigabeni sokuqala, kusetshenziswe umklamo owodwa wocwaningo, onamayunithi amancane amathathu akuleso simo, okungabahlengikazi abasebenza emitholampilo yabantu abadala, emitholampilo yemishanguzo yangaphambi kokubeletha neyezingane esibhedlela somphakathi esisezingeni eliphakeme. Ukuthatha isampula okuhlosiwe kwasetshenziselwa ukukhetha abahlengikazi abayisikhombisa. Idatha eyinhloko yaqoqwa kusetshenziswa izingxoxo ezihlelwe kancane. Umcwaningi wasebenzisa ukuhlaziywa kokuqukethwe njengoba kuchazwe u-Elo no-Kyngas (2008) ukuze ahlaziye izingxoxo ezibhaliwe eziseuselwa kokuqoshiwe. Izihloko ezihlonziwe zihlanganisa ubungozi bokuba nokukhathala ngokuphathelene nozwela, ukubonakaliswa kokukhathala ngokuphathelene nozwela namasu okuvimbela kanye nokwengammela ukukhathala ngokuphathelene nozwela. Ukuze kuhlaziywe amadokhumenti umcwaningi wasebenzisa incazelo yomsebenzi yo-enroled kanye no-professional nurse kanye nababhalisile kanye nohlelo lwezempilo nenhlalakahle yabasebenzela umphakathi. Esigabeni sesibili, umcwaningi wasungula uhlelo lwempilo ukuze asize ekuhlonzeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo kanye neye-Delphi Method yasetshenziselwa ukuthuthukisa uhlelo lokuphila kahle. Okutholakele: Abahlengikazi abasebenza emitholampilo yemishanguzo abasengozini yokuba nokukhathala ngenxa yezinkinga zendawo yokusebenza ezinjengezinselelo ezibangelwa uhlelo lokunakekelwa kwempilo, ukuntuleka kosizo oluvela kubaphathi, kanye nomsebenzi wabo omningi ngokweqile. Izindleko zobuhlobo bomhlengikazi nesiguli nazo zaba nomthelela ekutheni abahlengikazi babe sengozini yokukhathala ngokuphathelene nesihawu. Izici ezikhonjiwe ezihlobene nezindleko zobudlelwano neziguli ezineGciwane Lesandulela Ngculazi zihlanganisa ukunakekela iziguli ezihlukumezekile, ukuchayeka kokuhlangenwe nakho okubuhlungu ngokuphathelene neziguli, nethonya lokunakekela iziguli ezineGciwane Lesandulela Ngculazi kuye kwaba nalo ezimpilweni zomuntu uqobo zabahlengikazi nemindeni yabo. Abahlengikazi bangahlukumeza amalungu omndeni wabo ngokuqhubeka bengatholakali kubo ngenxa yokuhoxa ngokuphathele nomzwelo. Abahlengikazi bakhombise izimpawu ezingokomzimba, ezingokwengqondo, ezingokomoya kanye nezinguquko ekuziphatheni kwabo okubonisa ukukhathala ngokuphathelene nozwela. Kwaqashelwa amasu ahlukahlukene okuvimbela nokulawula ukukhathala ngokuphathelene nozwela: kokubili lokho abahlengikazi abangakwenza, nalokho ababekulindele kubaphathi. Incazelo yomsebenzi wabahlengikazi ijwayelekile futhi ayichazi indima yabo nokusebenza kwabo emitholampilo yemishanguzo. Kuyashoda ukuqaliswa kohlelo lwezempilo kanye nenhlalakahle. Okutholakele kweSigaba sokuqala sokubhaliwe okuhlobene nakho kwakha izisekelo lapho umcwaningi asungula khona uhlelo lokuphila kahle ukuze asize ekuhlonzeni, ekuvimbeleni kanye nasekwenganyelweni kokukhathala ngokuphathelene nozwela. Isiphetho: Abahlengikazi basengozini yokuba nokukhathala ngokuphathelene nozwela ngenxa yomthwalo wobudlelwano besiguli nomhlengikazi eziguli ezineGciwane Lesandulela Ngculazi. Isihluthulelo sokuvimbela ukukhathala kozwela ukuqwashisa futhi amasu amaningana angasiza ekukhombeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela asekhonjiwe futhi afakiwe ohlelweni lwezempilo. Ukusekelwa kwabaphathi kanye nokuzinakekela kubalulekile ukuze kulondolozwe impilo nenhlalakahle yabahlengikazi abasebenza emtholampilo wemishanguzo."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["PhD"]},{"key":"dc:title","label":"Title","values":["A wellness programme to prevent and manage compassion fatigue amongst nurses working in an anti-retroviral clinic in a public tertiary hospital"]}]}],"canonical_facts":{"dc:contributor.advisor":["Leech, Ronell"],"dc:date.accessioned":["2017-08-15T12:35:32Z"],"dc:date.available":["2017-08-15T12:35:32Z"],"dc:date.issued":["2016"],"dc:description":["Thesis (PhD)--University of Pretoria, 2016."],"dc:description.abstract":["English: Introduction: Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped and affects those who work in caring professions. Helping people in distress can traumatise the helper because of their empathetic ability. Nurses who work in ARV clinics witness the suffering of their patients when they listen to their patients' descriptions of the trauma that they have to cope with. The patients get the chance to let go of the trauma and to share their concerns. Unfortunately the nurses often absorb some of the emotional pain of their patients and not all nurses are equipped to handle the situations in such a way that they do not become secondarily affected by the trauma of their patients and therefore, become vulnerable to develop compassion fatigue. If compassion fatigue is not identified in time and addressed adequately, the affected nurses may develop feelings of hopelessness in their ability to take care of their patients with detrimental effect on the quality of nursing care to these patients. Aims: Firstly, to explore and describe the extent of the manifestation of compassion fatigue amongst nurses working in antiretroviral clinics; and secondly, to develop a wellness programme to aid in the identification and management of episodes of compassion fatigue as well as the prevention of future occurrences of such episodes of compassion fatigue amongst nurses working in antiretroviral clinics. Methodology: The researcher conducted the study in two phases. In Phase one, a single embedded case study design, with three sub-units situated within the case, namely nurses who work in the adult, ante-natal and paediatric ARV clinics in a tertiary public hospital, was used. Purposive sampling was used to select seven nurses. Data was collected using semi-structured interviews. The researcher used content analysis as described by Elo and Kyngäs (2008) to analyse the transcribed interviews. The themes identified include the risk to develop compassion fatigue, manifestation of compassion fatigue and strategies to prevent and manage compassion fatigue. For document analysis the researcher used professional and enrolled nurses' job description and the employee health and wellness programme for public service. In Phase two, the researcher developed the wellness programme to aid in the identification, prevention and management of compassion fatigue amongst nurses who work in antiretroviral clinics and the Delphi Method was used to refine the wellness programme. Findings: Nurses working in the ARV clinics are at risk of developing compassion fatigue due to work environment issues such as challenges created by the health care system, lack of support from management, and their overwhelming work load. The cost of the nurse-patient relationship also contributed to nurses being at risk of compassion fatigue. Aspects that were identified that relate to the cost of a relationship with patients who are HIV positive include caring for traumatised patients, vicarious exposure to traumatic experiences of patients, and the influence caring for patients who are HIV positive has had on nurses' personal lives and their families. Nurses can traumatise their family members by continually not being available for them through emotional withdrawal. Nurses presented with physical, psychological, spiritual symptoms and changes in their behaviour that are indicative of compassion fatigue. Various strategies to prevent and manage compassion fatigue were identified: both what nurses can do, and what they expected from management. Nurses' job description is generic and does not spell out their role and function within antiretroviral clinics. The implementation of the health and wellness programme is lacking. The findings of Phase one and related literatures formed the bases from which the researcher developed the wellness programme to aid with the identification, prevention and management of compassion fatigue. Conclusion: Nurses are at risk of developing compassion fatigue due to the cost of the nurse-patient relationship with patients who are HIV positive. The key to prevention of compassion fatigue is awareness and a number of strategies that can aid in the identification, prevention and management of compassion fatigue have been identified and included in the wellness programme. Managerial support and practicing of self-care is important to maintain the health and well-being of nurses who work in antiretroviral clinic. Sepedi: Matseno: Molapo ka kwelobohloko ke boemo bjo bo feteletšego bja kgatelelo le go swarega ka tlaišego ya bao ba thušwago gomme bo ama bao ba šomago diprofešeneng tša tlhokomelo. Go thuša batho bao ba lego tlalelong go ka kweša mothuši bohloko ka lebaka la bokgoni bja bona bja kwelobohloko. Baoki bao ba šomago dikliniking tša ARV ba hlatsela tlaišego ya balwetši ba bona ge ba theeletša ditlhalošo tša balwetši ba bona ka lešoko leo ba swanetšego go šogana le lona. Balwetši ba hwetša sebaka sa go tlogela lešoko le go abelana dipelaelo tša bona. Ka bomadimabe baoki gantši ba angwa ke maikutlo bja balwetši ba bona gomme ga se baoki ka moka bao ba hlometšwego go swaragana le maemo ka tsela yeo ba sa amegego ka tsela ya bobedi ke masetlapelo a balwetši ba bona gomme ka fao, ba ba kotsing ya go kgotlelela molapo wa kwelobohloko. Ge e ba go lapa ga kwelobohloko go sa lemogwe ka nako gomme gwa rarollwa ka mo go lekanego, baoki bao ba amilwego ba ka ba le maikutlo a go hloka kholofelo bokgoning bja bona bja go hlokomela balwetši ba bona ka mafelelo a kotsi boleng bja tlhokomelo ya booki go balwetši ba. Dinepo: Sa mathomo, go hlohlomiša le go hlaloša bogolo bja ponagatšo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale; le sa bobedi, go hlama lenaneo la bophelo bjo kaone go thuša go šupa le go laola ditiragalo tša molapo ka kwelobohloko gammogo le thibelo ya ditiragalo tša ka moso tša ditiragalo tše bjalo tša molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale. Mokgwa: Monyakišiši o dirile dinyakišišo tše ka dikgato tše pedi. Mo Kgatong ya pele, go šomišitšwe tlhamo e tee ya nyakišišo ya mohlala ye e tsentšwego, yeo e nago le diyuniti tše tharo tše nnyane tšeo di lego ka gare ga molato, e lego baoki bao ba šomago ka dikliniking tša ARV tša batho ba bagolo, pele ga pelego le tša bana sepetleleng sa setšhaba sa maemo a godimo. Go ile gwa dirišwa go tšea mehlala ka morero go kgetha baoki ba šupago. Datha e kgobokeditšwe ka go šomiša dipoledišano tšeo di sego tša rulaganywa gabotse. Monyakišiši o šomišitše tshekatsheko ya diteng bjalo ka ge e hlalošitšwe ke Elo le Kyngas (2008) go sekaseka dipoledišano tšeo di ngwadilwego. Merero ye e lemogilwego e akaretša kotsi ya go hlabolla molapo ka kwelobohloko, ponagatšo ya molapo ka kwelobohloko le maano a go thibela le go laola molapo ka kwelobohloko. Bakeng sa tshekatsheko ya ditokumente monyakišiši o šomišitše tlhalošo ya mošomo ya baoki ba profešenale le bao ba ngwadišitšwego le lenaneo la maphelo le bophelo bjo kaone bja bašomi bakeng sa tirelo ya setšhaba. Mo Kgatong ya bobedi, monyakišiši o hlamile lenaneo la bophelo bjo bobotse go thuša go šupa, thibelo le taolo molapo ka kwelobohloko gare ga baoki bao ba šomago ka dikliniking tša anthiretherobaerale gomme Mokgwa wa Delphi o šomišitšwe go kaonafatša lenaneo la maphelo. Diphihlelelo: Baoki bao ba šomago ka dikliniking tša ARV ba kotsing ya go ba le molapo ka kwelobohloko ka lebaka la ditaba tša tikologo ya mošomo go swana le ditlhohlo tšeo di hlotšwego ke tshepedišo ya tlhokomelo ya maphelo, go hloka thekgo go tšwa go bolaodi, le mošomo wa bona wo montši. Ditshenyagalelo tša tswalano ya mooki le molwetši le tšona di bile le seabe go baoki go ba kotsing ya molapo ka kwelobohloko. Dikarolo tšeo di lemogilwego tšeo di amanago le ditshenyagalelo tša tswalano le balwetši bao ba nago le HIV di akaretša go hlokomela balwetši bao ba gatelegilego, go pepentšhwa ga legato diphihlelo tše di kwešago bohloko tša balwetši, le khuetšo yeo go hlokomela balwetši bao ba nago le HIV go bilego le yona maphelong a baoki ka noši le malapeng a bona. Baoki ba ka gatelela menagano ya ditho tša lapa la bona ka go se hwetšagale ka mo go tšwelago pele bakeng sa bona ka go ikgogela morago maikwelong. Baoki ba ile ba tšweletša dika tša mmele, tša monagano, tša moya le diphetogo boitshwarong bja bona tšeo di bontšhago go lapa ga kwelobohloko. Maano a go fapafapana a go thibela le go laola go lapa ga kwelobohloko a ile a lemogwa: bobedi seo baoki ba ka se dirago, le seo ba bego ba se letetše go tšwa go taolo. Tlhalošo ya mošomo ya baoki ke ya kakaretšo gomme ga e pelete tema ya bona le mošomo ka gare ga dikliniki tša anthiretherobaerale. Phethagatšo ya lenaneo la maphelo le bophelo bjo kaone e a hlaelela. Diphihlelelo tša Kgato ya pele le dingwalo tše di amanago le yona di bopile metheo yeo go tšwa go yona monyakišiši a hlamilego lenaneo la maphelo a kaone go thuša ka go hlaola, thibelo le taolo ya molapo ka kwelobohloko. Sephetho: Baoki ba kotsing ya go ba le go lapa ga kwelobohloko ka lebaka la ditshenyagalelo tša kamano ya mooki le molwetši le balwetši bao ba nago le HIV. Bohlokwa bja thibelo ya molapo ka kwelobohloko ke temošo gomme maano a mmalwa ao a ka thušago go laetša, thibelo le taolo ya molapo ka kwelobohloko a lemogilwe le go akaretšwa lenaneong la bophelo bjo kaone. Thekgo ya bolaodi le go itlwaetša go itlhokomela go bohlokwa go hlokomela maphelo le bophelo bjo kaone bja baoki bao ba šomago kliniking ya anthiretherobaerale. Afrikaans: Inleiding: Empatie-uitputting is ’n uiterste toestand van spanning en beheptheid met die lyding van diegene wat gehelp word, en beïnvloed diegene wat in sorgberoepe werk. Om mense in nood te help, kan die helper traumatiseer as gevolg van hul vermoë tot empatie. Verpleegkundiges wat in ARV-klinieke werk, sien hul pasiënte se lyding wanneer hulle luister hoe hul pasiënte die trauma beskryf waarmee hulle te doen het. Die pasiënte kry die geleentheid om die trauma te laat vaar en hul bekommernisse te deel. Ongelukkig absorbeer verpleegsters dikwels van die emosionele pyn van hul pasiënte, en nie alle verpleegsters het die vermoë om die situasies so te hanteer dat hulle nie sekondêr deur die trauma van hul pasiënte geraak word nie, wat hulle kwesbaar maak om empatie-uitputting te ontwikkel. Indien empatie-uitputting nie betyds geïdentifiseer en voldoende hanteer word nie, kan die geaffekteerde verpleegkundiges hopeloos begin voel oor hul vermoë om vir hul pasiënte te sorg, wat ’n nadelige uitwerking op die gehalte van verpleegsorg aan hierdie pasiënte het. Doelwitte: Eerstens, om die omvang en die voorkoms van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, te ondersoek en te beskryf; en tweedens, om ’n welstandsprogram te ontwikkel wat voorvalle van empatie-uitputting kan help identifiseer en bestuur, asook toekomstige voorvalle van empatie-uitputting help voorkom onder verpleegkundiges wat in antiretrovirale klinieke werk. Metodologie: Die navorser het die studie in twee fases uitgevoer. In Fase Een is ’n enkele ingebedde gevallestudie-ontwerp gebruik, met drie subeenhede binne die geval, naamlik verpleegkundiges wat in die volwasse, die voorgeboortelike en die pediatriese ARV-klinieke van ’n tersiêre openbare hospitaal werk. Doelgerigte steekproefneming is gebruik om sewe verpleegkundiges te kies. Data is by wyse van semi-gestruktureerde onderhoude ingesamel. Die navorser het inhoudsontleding soos beskryf deur Elo en Kyngas (2008) gebruik om die getranskribeerde onderhoude te ontleed. Die geïdentifiseerde temas behels die risiko om empatie-uitputting te ontwikkel, die voorkoms van empatie-uitputting, en strategieë om empatie-uitputting te voorkom en te bestuur. Vir dokumentontleding het die navorser die posbeskrywings van professionele en ingeskrewe verpleegkundiges, en die werknemergesondheid- en welstandsprogram vir openbare diens gebruik. In Fase Twee het die navorser die welstandsprogram ontwikkel om te help met die identifisering, voorkoming en bestuur van empatie-uitputting onder verpleegkundiges wat in antiretrovirale klinieke werk, en die Delphi-metode gebruik om die welstandsprogram te verfyn. Bevindinge: Verpleegkundiges wat in die ARV-klinieke werk, loop die risiko om empatie-uitputting te ontwikkel as gevolg van werkomgewingskwessies soos uitdagings wat deur die gesondheidsorgstelsel geskep word, ’n gebrek aan ondersteuning deur die bestuur, en hul oorweldigende werklas. Die prys wat die verpleegster-pasiënt-verhouding eis, het ook tot die risiko van empatie-uitputting onder verpleegsters bygedra. Aspekte wat geïdentifiseer is as bydraend tot die prys van ’n verhouding met pasiënte wat MIV-positief is, sluit in die versorging van getraumatiseerde pasiënte, plaasvervangende blootstelling aan die traumatiese ervarings van pasiënte, en die invloed wat sorg aan pasiënte wat MIV-positief is op verpleegsters se persoonlike lewens en hul gesinne gehad het. Verpleegsters kan hul gesinslede traumatiseer deur voortdurend nie vir hulle beskikbaar te wees nie weens emosionele onttrekking. Verpleegkundiges het fisieke, sielkundige en geestelike simptome en gedragsveranderinge getoon, wat tekens van empatie-uitputting is. Verskeie strategieë om empatie-uitputting te voorkom en te bestuur, is geïdentifiseer: sowel wat verpleegkundiges kan doen as wat hulle van bestuur verwag. Verpleegkundiges se posbeskrywing is generies, en spel nie hul rol en funksie in antiretrovirale klinieke uit nie. Die gesondheids- en welstandsprogram word nie geïmplementeer nie. Die bevindinge van Fase Een en verwante literatuur het die basis gevorm waarop die navorser die welstandsprogram gebou het om te help met die identifisering, voorkoming en bestuur van empatie-uitputting. Gevolgtrekking: Verpleegkundiges loop die risiko om empatie-uitputting te ontwikkel as gevolg van die prys van die verpleegster-pasiënt-verhouding met pasiënte wat MIV-positief is. Die sleutel tot die voorkoming van empatie-uitputting is bewustheid, en ’n aantal strategieë wat kan help met die identifisering, voorkoming en bestuur van empatie-uitputting is geïdentifiseer en in die welstandsprogram opgeneem. Ondersteuning deur die bestuur, en die beoefening van selfsorg, is belangrik vir die handhawing van die gesondheid en welstand van verpleegkundiges wat in antiretrovirale klinieke werk. IsiZulu: Isingeniso: Ukukhathala ngokuphathelene nozwela kuyisimo esibi kakhulu sokucindezeleka nokukhathazeka ngokuhlupheka kwalabo abasizwayo futhi kuthinta labo abasebenza emisebenzini yokunakekela. Ukusiza abantu abasosizini kungamhlukumeza umsizi ngenxa yokuba kwakhe nozwela. Abahlengikazi abasebenza emitholampilo yama-ARV bayakubona ukuhlupheka kweziguli zabo lapho belalela izincazelo zeziguli zabo ngosizi okumelwe zibhekane nalo. Iziguli zithola ithuba lokudedela ukuhlukumezeka nokwabelana ngezinto ezikukhathazayo. Ngeshwa abahlengikazi bavame ukuthatha obunye ubuhlungu obungokomzwelo beziguli zabo futhi akubona bonke abahlengikazi abahlonyiselwe ukusingatha izimo ngendlela yokuthi bangathinteki okwesibili ekucindezelekeni kweziguli zabo futhi ngenxa yalokho, babe sengozini yokuba nokukhathala ngokuphathelene nozwela. Uma ukukhathala kozwela kungabonakali ngesikhathi futhi kusingathwa ngokwanele, abahlengikazi abathintekayo bangase babe nemizwa yokuphelelwa yithemba emandleni abo okunakekela iziguli zabo okunomthelela omubi ezingeni lokunakekelwa kwabahlengikazi kulezi ziguli. Izinhloso: Okokuqala, ukuhlola nokuchaza ubukhulu bokubonakaliswa kokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yezidambisigciwane; futhi okwesibili, ukusungula uhlelo lokuphila kahle lokusiza ekuhlonzeni nasekulawuleni iziqephu zokukhathala kozwela kanye nokuvimbela izehlakalo zesikhathi esizayo zeziqephu ezinjalo zokukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo. Indlela yokwenza: Umcwaningi wenza ucwaningo ngezigaba ezimbili. Esigabeni sokuqala, kusetshenziswe umklamo owodwa wocwaningo, onamayunithi amancane amathathu akuleso simo, okungabahlengikazi abasebenza emitholampilo yabantu abadala, emitholampilo yemishanguzo yangaphambi kokubeletha neyezingane esibhedlela somphakathi esisezingeni eliphakeme. Ukuthatha isampula okuhlosiwe kwasetshenziselwa ukukhetha abahlengikazi abayisikhombisa. Idatha eyinhloko yaqoqwa kusetshenziswa izingxoxo ezihlelwe kancane. Umcwaningi wasebenzisa ukuhlaziywa kokuqukethwe njengoba kuchazwe u-Elo no-Kyngas (2008) ukuze ahlaziye izingxoxo ezibhaliwe eziseuselwa kokuqoshiwe. Izihloko ezihlonziwe zihlanganisa ubungozi bokuba nokukhathala ngokuphathelene nozwela, ukubonakaliswa kokukhathala ngokuphathelene nozwela namasu okuvimbela kanye nokwengammela ukukhathala ngokuphathelene nozwela. Ukuze kuhlaziywe amadokhumenti umcwaningi wasebenzisa incazelo yomsebenzi yo-enroled kanye no-professional nurse kanye nababhalisile kanye nohlelo lwezempilo nenhlalakahle yabasebenzela umphakathi. Esigabeni sesibili, umcwaningi wasungula uhlelo lwempilo ukuze asize ekuhlonzeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela phakathi kwabahlengikazi abasebenza emitholampilo yemishanguzo kanye neye-Delphi Method yasetshenziselwa ukuthuthukisa uhlelo lokuphila kahle. Okutholakele: Abahlengikazi abasebenza emitholampilo yemishanguzo abasengozini yokuba nokukhathala ngenxa yezinkinga zendawo yokusebenza ezinjengezinselelo ezibangelwa uhlelo lokunakekelwa kwempilo, ukuntuleka kosizo oluvela kubaphathi, kanye nomsebenzi wabo omningi ngokweqile. Izindleko zobuhlobo bomhlengikazi nesiguli nazo zaba nomthelela ekutheni abahlengikazi babe sengozini yokukhathala ngokuphathelene nesihawu. Izici ezikhonjiwe ezihlobene nezindleko zobudlelwano neziguli ezineGciwane Lesandulela Ngculazi zihlanganisa ukunakekela iziguli ezihlukumezekile, ukuchayeka kokuhlangenwe nakho okubuhlungu ngokuphathelene neziguli, nethonya lokunakekela iziguli ezineGciwane Lesandulela Ngculazi kuye kwaba nalo ezimpilweni zomuntu uqobo zabahlengikazi nemindeni yabo. Abahlengikazi bangahlukumeza amalungu omndeni wabo ngokuqhubeka bengatholakali kubo ngenxa yokuhoxa ngokuphathele nomzwelo. Abahlengikazi bakhombise izimpawu ezingokomzimba, ezingokwengqondo, ezingokomoya kanye nezinguquko ekuziphatheni kwabo okubonisa ukukhathala ngokuphathelene nozwela. Kwaqashelwa amasu ahlukahlukene okuvimbela nokulawula ukukhathala ngokuphathelene nozwela: kokubili lokho abahlengikazi abangakwenza, nalokho ababekulindele kubaphathi. Incazelo yomsebenzi wabahlengikazi ijwayelekile futhi ayichazi indima yabo nokusebenza kwabo emitholampilo yemishanguzo. Kuyashoda ukuqaliswa kohlelo lwezempilo kanye nenhlalakahle. Okutholakele kweSigaba sokuqala sokubhaliwe okuhlobene nakho kwakha izisekelo lapho umcwaningi asungula khona uhlelo lokuphila kahle ukuze asize ekuhlonzeni, ekuvimbeleni kanye nasekwenganyelweni kokukhathala ngokuphathelene nozwela. Isiphetho: Abahlengikazi basengozini yokuba nokukhathala ngokuphathelene nozwela ngenxa yomthwalo wobudlelwano besiguli nomhlengikazi eziguli ezineGciwane Lesandulela Ngculazi. Isihluthulelo sokuvimbela ukukhathala kozwela ukuqwashisa futhi amasu amaningana angasiza ekukhombeni, ekuvimbeleni nasekulawuleni ukukhathala kozwela asekhonjiwe futhi afakiwe ohlelweni lwezempilo. Ukusekelwa kwabaphathi kanye nokuzinakekela kubalulekile ukuze kulondolozwe impilo nenhlalakahle yabahlengikazi abasebenza emtholampilo wemishanguzo."],"dc:description.degree":["PhD"],"dc:identifier.other":["A2017"],"dc:identifier.uri":["http://hdl.handle.net/2263/61672"],"dc:language.iso":["en"],"dc:publisher":["University of Pretoria"],"dc:rights":["© 2017 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria."],"dc:subject":["UCTD","Compassion fatigue","HIV/AIDS","Wellness programmes","Delphi Method"],"dc:title":["A wellness programme to prevent and manage compassion fatigue amongst nurses working in an anti-retroviral clinic in a public tertiary hospital"],"dc:type":["Thesis"]},"updated_at":"2026-07-24T03:52:21Z"}