Abstract
D.Cur.
Health care professionals, in all settings, have become increasingly aware of the consumers' legitimate right to participate in decision-making regarding care to be received. Health professionals have also being criticised for planning and delivering care that does not take into consideration the client's perceived needs, wishes and expectations of such care. This study is undertaken primarily to explore and describe the expectations of both the care-givers (midwives, student-midwives and doctors) and the health care consumers (mothers and fathers). The focus of the study is the care to be provided to mothers by midwives during labour. It is the aim of the researcher to ameliorate lapses in the provision of comprehensive health care.
The study design is exploratory, descriptive, qualitative and contextual in nature. The main purpose of this study is to formulate guidelines for implementation by the midwife during labour. In order to accomplish this purpose, the research study followed six (6) distinct phases in which different objectives were addressed. In Phase 1, the expectations of mothers and partners/fathers concerning the care to be provided by the midwives during labour were explored. These were described after conducting in-depth qualitative interviews with both the mothers and partners/fathers. In Phase 2, focus group discussions were conducted with the midwives and studentmidwives, to explore and describe their expectations concerning the care to be provided by the midwives during labour. In Phase 3, narratives were gathered from selected doctors, in which they explored and described their expectations concerning the care to be provided to the mothers by midwives during labour.
The results of the interviews, focus group discussions and narratives were subsequently analysed based on categories of "Theory for Health Promotion in Nursing (Department of Nursing Science, RAU, 1998)". The results were also contextualised. A concept analysis was conducted in Phase 4 in order to identify the characteristics of the concept "Caring" using different situations where caring takes place, from literature sources (uses of the concept) as well as the two main themes which emerged from the research results. Thereafter, the identified characteristics of Caring were placed in comparison with the research results obtained from Phase 1, 2 and 3 and were reduced under the following headings: Prerequisites, Process and Consequences.
From this process the concept "Caring" was defined. In Phase 5 of the study, a conceptual framework was developed out of all the characteristics determined from the concept analysis and was discussed in three phases namely, the initial, integration and termination. In the final phase, that is Phase 6, the guidelines for operationalising caring during labour were formulated from all the characteristics determined from the concept analysis and the following headings were maintained that is, Prerequisites, Process and Consequences. These guidelines were evaluated and refined by the midwives and student-midwives from the specific hospital where data was collected.
The conclusions and trustworthiness of this study were discussed. Recommendations were made in terms of highlighting the possibilities of application of the guidelines for operationalising caring during labour in nursing education, nursing practise and nursing research.