Introduction: “Unhappy people cannot create a society enjoying wellbeing” (Ataltarartseva and Barysheva, 2015:36). This statement in the context of the Transnet-Phelophepa Health Care Train (HCT) implies the importance of maintaining service providers’ health and well-being as they have a responsibility of creating a society, enjoying well-being through health services that are provided by this mobile health care project, the Transnet-Phelophepa HCT.
The overall aim of this research project was to explore and describe service providers and service users’ experiences of the Transnet-Phelophepa HCT in order to make recommendations for health and well-being on the health care train. In the context of this study, King’s (1981) theoretical framework was used to guide the process of identifying key constructs of health and well-being that were researched.
The main facets of health and well-being researched based on Kings (1981) personal interpersonal and social interacting system model are: safety climate, job content, decision latitude, work stress, as well as quality of life and service users satisfaction with the service provided.
Methodology: Based on the methodological assumptions, a mixed methods embedded case study design was adopted for this study and implemented in two phases. In Phase 1 a convergent parallel design was applied wherein five quantitative surveys and qualitative in-depth interviews were conducted for the purpose of exploring and describing health and well-being on the Transnet-Phelophepa HCT.
Data Collection: Two quantitative surveys were employed to collect data from a sample of 257 health science students (n=257). The first survey explored their perceptions of the train’s safety climate and the second survey determined decision latitude and supervisor support. The third and fourth surveys collected data from permanent employees (n=19) to determine their sources of work stress and perceptions of their quality of life on the Transnet-Phelophepa HCT. The last survey explored service users’ perceptions of the health care provided on the Transnet-Phelophepa HCT. Data were collected from a sample of service users (n=124). A qualitative study exploring permanent employees’ experiences of life on the Transnet-Phelophepa HCT was conducted using in-depth interviews to collect data from participants (n=8) until data saturation was reached.
Data analysis: In phase 2, Onwuegbuzie and Teddlie’s (2003) seven-stage conceptualization of the mixed methods data analysis process was applied for the purpose of formulating recommendations for health and well-being on the Phelophepa HCT.
Results: The main findings of the study were constructed within King’s (1981) conceptual model addressing the main facets of well-being.
The main facets of health and well-being emerging from the results include the following: Personal systems are discussed in the context of space. The Phelophepa HCT is perceived as a safe environment. However, concerns were raised regarding the possibility of occupational health and safety hazards. Interpersonal systems related facets are: supervisor support, co-workers relations as perceived by students as well as permanent employees perceptions of sources of stress on the Transnet-Phelophepa HCT. Social systems are discussed in relation to: health care service provision, work-home balance as well as authority, decision making and control.
RECOMMENDATIONS
The recommendations formulated do not follow the convention of “research”, “education” and “practice” but are rather integrated into the different facets of the main findings.
Policy and operations
Establish a safety climate programme that will ensure active service providers participation in safety issues in the Transet- Phelophepa HCT.
Develop programmes that will contribute towards work-home related quality of life as work balance was identified as the highest moderate source of stress.
Research
In view of the fact that the study was conducted in only one of the health trains, the recommendation is for a more comprehensive, comparative study on both health care trains. The areas of focus would be to:
ascertain the attributes of good student-support. The findings will be used to develop student-support best practice guidelines for the Transnet-Phelophepa HCT.
Health Ministry: Expand availability of mobile health care services through adoption of the Transnet-Phelophepa HCT as a practice model of providing the scarce and mostly needed services in partnership with the private sector there is evidence of willingness from the private businesses to support health services.
KEY WORDS: Transnet-Phelophepa Health Care Train, community health, well-being
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