Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620180001&lang=es vol. 23 num. lang. es <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Challenges in implementing continuous support during childbirth in selected public hospitals in the North West Province of South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100001&lng=es&nrm=iso&tlng=es BACKGROUND: According to a Cochrane review, continuous support during childbirth increases the mother's chances of a vaginal birth without identified adverse effects. However, this evidence-based practice is not universally implemented. The objective of the study was to identify challenges encountered in implementing continuous support during childbirth in public hospitals in the North West Province of South Africa. METHOD: An explorative, descriptive and contextual qualitative approach was used. The data were collected during 2013 by conducting focus group interviews with 33 registered midwives who had worked in maternity units in three selected public hospitals in the North West Province for at least two years. RESULTS: Midwives identified challenges that negatively impacted the implementation of continuous support during childbirth at organisational and interpersonal levels. At the organisational level, challenges included human resources, policies and guidelines as well as the architectural outlay of the maternity units. The personal challenges related to communication and attitudes of nurses, patients and their families. CONCLUSIONS: Organisational and personal challenges had a negative impact on the provision of continuous care during childbirth. <![CDATA[<b>Neonatal chest image quality addressed through training to enhance radiographer awareness</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100002&lng=es&nrm=iso&tlng=es BACKGROUND: Diagnostic radiographers working in the neonatal intensive care unit primarily aim to produce an image of optimal quality using optimal exposure techniques without repeating exposures, to keep neonatal radiation dose to a minimum. OBJECTIVES: The aim of the study was to determine whether radiographers were producing optimal quality chest images and, if not, whether additional training could contribute to reaching this goal in the Free State Province of South Africa. METHODS: Neonatal chest image quality was determined in the Neonatal Intensive Care Unit by using a checklist based on and compiled from published guidelines to evaluate the quality of 450 randomly-selected images. Thereafter, a training programme was designed, based on the evaluation criteria of the checklist and image quality areas identified. The training also referred to positioning techniques that should be applied to ensure optimal image quality. After presentation of the training, 450 newly-produced neonatal chest images were evaluated. These images were selected through purposive sampling as this evaluation only included images of participating radiographers who completed the training. RESULTS: Image quality that showed significant improvement included a reduction in electrocardiogram lines superimposed on chest anatomy, a tendency to centre closer to thoracic vertebra four, and visible four-sided collimation on images. Image quality areas with no significant enhancement were the absence of lead markers and radiation shielding. CONCLUSION: The study has shown that a training programme has the potential to improve neonatal chest image quality. <![CDATA[<b>Challenges experienced by postgraduate nursing students at a South African university</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100003&lng=es&nrm=iso&tlng=es BACKGROUND: The increase in nurses enrolling in postgraduate programmes as well as the need to improve their completion requires academics to establish environments conducive for postgraduate studies. The challenges experienced during postgraduate studies have to be identified to establish conducive environments. OBJECTIVE: The objective of this study was to explore and describe the challenges experienced by postgraduate nursing students enrolled in postgraduate coursework and research programmes at a South African university. METHODS: An exploratory, descriptive and qualitative design was used. The study was contextual in nature. Purposive sampling was used. Fifteen honours, master's and doctoral students participated in the study. Data were analysed through qualitative content analysis and measures to ensure trustworthiness, and ethical implementation of the study were implemented. RESULTS: Three themes with categories were identified, namely personal challenges (i.e. finances, employment, family and accommodation), academic and institutional challenges (i.e. workload and time constraints, contact sessions, subject information and assessment) and research-related challenges (i.e. information literacy, supervisory relationship and supervisory structure and process. CONCLUSION: Institutional support addressing personal, academic and research-related challenges should be provided to enhance student experiences and completion. <![CDATA[<b>Prevalence and factors associated with low back pain among nurses at a regional hospital in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100004&lng=es&nrm=iso&tlng=es BACKGROUND: Low back pain (LBP) is a public health problem worldwide and is a common cause of work-related disorder among workers, especially in the nursing profession. Recruitment and retention of nurses is a challenge, and the nursing shortage has been exacerbated by the burden of occupational injuries such as LBP and related disabilities. The physiotherapy clinical records revealed that caseload of nurses presenting for the management of LBP was increasing. The prevalence and factors associated with LBP were unclear. METHODS: A cross-sectional study design with an analytic component was implemented. Data were collected utilising a self-administered questionnaire to determine the prevalence and factors associated with LBP among nurses at a regional hospital. Bivariate analyses were performed to determine the factors associated with LBP. RESULTS: The point prevalence of current LBP in nurses was 59%. The highest prevalence was recorded among enrolled nurses (54%), respondents aged 30-39 (46%), overweight respondents (58%) and those working in obstetrics and gynaecology (49%). Bending (p = 0.002), prolonged position (p = 0.03) and transferring patients (p = 0.004) were strongly associated with LBP. Nurses with more than 20 years in the profession reported a high prevalence of LBP. The prevalence of LBP was higher among the participants who were on six-month rotations (76%) compared with those on yearly rotation (16%). CONCLUSION: A high proportion of nurses reported to have LBP. Occupational factors are strongly associated with LBP. Education programmes on prevention and workplace interventions are required in order to reduce occupational injuries. <![CDATA[<b>Recognition of prior learning candidates' experiences in a nurse training programme</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100005&lng=es&nrm=iso&tlng=es Recognition of prior learning (RPL) in South Africa is critical to the development of an equitable education and training system. Historically, nursing has been known as one of the professions that provides access to the training and education of marginalised groups who have minimal access to formal education. The advent of implementing RPL in nursing has, however, not been without challenges. The purpose of this study was to explore and describe the experiences of RPL nursing candidates related to a 4-year comprehensive nursing training programme at a nursing education institution in Gauteng. An exploratory, descriptive and contextual qualitative research design was undertaken. The research sample comprised 13 purposefully selected participants. Face-to-face individual interviews, using open-ended questions, were used to collect data, which were analysed using Tesch's approach. Recognition of prior learning candidates experienced a number of realities as adult learners. On a positive note, their prior knowledge and experience supported them in their learning endeavours. Participants, however, experienced a number of challenges on personal, interpersonal and socialisation, and educational levels. It is important that opportunities are created to support and assist RPL candidates to complete their nursing training. This support structure, among others, should include the provision of RPL-related information, giving appropriate advice, coaching and mentoring, effective administration services, integrated curriculum design, and a variety of formative and summative assessment practices. <![CDATA[<b>Psychiatric nurses' experience of aggression amongst colleagues</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100006&lng=es&nrm=iso&tlng=es Psychiatric nurses run a high risk of being exposed to aggression. They experience aggression from clients as well as fellow colleagues. Aggression in the work environment has an overt negative psychological effect on the nurse. The purpose of this research was to explore and describe how psychiatric nurses experienced aggression amongst colleagues in the work environment. The study used a qualitative, exploratory and descriptive research design. Eight psychiatric nurses exposed to aggression by their colleagues in an academic psychiatric hospital in Johannesburg were purposively sampled to participate in this study. Data were collected by means of in-depth phenomenological interviews, observations and field notes until data saturation was achieved. The following question was asked: 'What is your experience of aggression amongst colleagues in the work environment?'. The findings indicated that the psychiatric nurses experienced aggression in a passive but harmful manner. The nurses experienced a suspicious and distrustful team environment. Limited support was experienced when colleagues and management did not acknowledge aggression and the nurses applied various coping and defence mechanisms when emotional stress and aggression were experienced. The aggression psychiatric nurses experienced had an effect on their experience on self, team work and providing services to patients. <![CDATA[<b>Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals' perspectives and strategies</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100007&lng=es&nrm=iso&tlng=es PURPOSE: International and national research regarding the discussion of cancer treatment across cultural boundaries is sparse. This study was conducted in the province of KwaZulu-Natal, South Africa, where healthcare encounters are largely culturally discordant; and this study focused on adult Zulu patients diagnosed with osteosarcoma. The purpose of this research study was to identify the cultural factors associated with discussing the different treatment options - and to explore healthcare professionals' responses to these cultural factors - from the healthcare professionals' perspective. METHODS: A qualitative, exploratory, descriptive and contextual research design was used. We conducted focus group interviews with professional nurses, allied health professionals and orthopaedic physicians. These three focus groups comprised a total of 23 participants, and interviews were conducted with each of these groups. We thematically analysed the interview transcripts, using Guba's model of trustworthiness to ensure rigour. RESULTS: We found that the factors, influencing treatment discussions in this cross-cultural clinical setting, included the meaning and the disclosure of cultural health beliefs. We identified strategies for responding to the cultural factors associated with amputation, namely timing treatment discussions, using support services, patient models and DVDs or videos. Strategies for responding to cultural and health beliefs that affect the treatment included initiating the cultural discussion, demonstrating an understanding of patients' cultural beliefs and liaising with family and cultural decision-makers wherever possible. CONCLUSION: Our findings emphasised healthcare professionals' reports of how patients can experience the discussion of culturally discordant treatment options as bad news. We recommend that the treatment discussion form an integral part of the guidelines for culturally competent communication with such cancer patients. <![CDATA[<b>Early childhood caries and dental treatment need in low socio-economic communities in Cape Town, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100008&lng=es&nrm=iso&tlng=es BACKGROUND: Early childhood caries (ECC) is a particularly severe problem in low socio-economic communities which impacts the overall health and well-being of children. The extensive waiting lists for general anaesthesia and sedation services at the only tertiary dental care centre in the study area for the treatment of children with ECC were an indication of the extent of the problem. The true extent of the problem in this area was, however, not known. This information is crucial in order to plan and execute remedial measures. AIM: To assess the prevalence of oral and dental problems, especially ECC, in children under six years of age in the study population, and ascertain their need for dental treatment. METHODS: A cross-sectional survey of 659 children from selected schools and clinics in the study area was carried out between 2010 and 2013. RESULTS: A caries prevalence of 71.6% (472/659) was recorded. Of these, 67.5% (445/659) of children were in need of dental treatment. CONCLUSION: Over the last decade, there has been no improvement in the caries status of children in the study population, and no organised measures have been put in place to address this problem. Awareness needs to be raised so that governments, especially in developing countries, can take appropriate measures to alleviate this public health problem. Time and resources have to be invested in the education of all health professionals dealing with children, by raising their awareness of the early stages of the disease so that timeous referrals can be made. <![CDATA[<b>Increasing coping and strengthening resilience in nurses providing mental health care: Empirical qualitative research</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100009&lng=es&nrm=iso&tlng=es BACKGROUND: Research on coping and resilience is on the rise. However, there is a paucity of information addressing strengths, assets, competence or resilience that enable nurses to remain committed and cope in their profession despite the adversities they face in their working environment. OBJECTIVE: The purpose of this research was to explore and describe how to strengthen the resilience of nurses in a work environment with involuntary mental health care users. METHOD: An exploratory and descriptive research design, which is contextual in nature, was used. RESULTS: Narrative responses to two open-ended questions (How do you cope with providing mental health care to involuntary admitted mental health care users? and; How can your resilience be strengthened to provide mental health care to involuntary mental health care users?) yielded coping mechanisms and resilience strengthening strategies. CONCLUSION: Nurses caring for involuntary mental health care users are faced with challenging situations while they themselves experience internal conflict and have limited choices available to be assertive. To strengthen their resilience, the following factors should be taken into account: support, trained staff, security measures and safety, teamwork and in-service training and education. <![CDATA[<b>Process of development of a contemporary curriculum in advanced midwifery</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100010&lng=es&nrm=iso&tlng=es BACKGROUND: We identified the need for a contemporary curriculum to enhance education in advanced midwifery. Midwifery education needs to address the changing health needs, meet the requirements of the educational framework in South Africa and align with international trends. AIM: The aim was to describe the development of a contemporary curriculum for advanced midwifery. SETTING: The curriculum development took place at a South African university. METHOD: We used a situational analysis to create a contemporary curriculum based on the Research Development and Diffusion Model. RESULTS: We described the process followed for the situation analysis towards the development of a contemporary curriculum in advanced midwifery which is aligned with global trends. CONCLUSION: A situation analysis of the existing curriculum, the community and country's maternal and neonatal needs, educational framework and global trends should be used to develop the intended contemporary curriculum. <![CDATA[<b>An overview of the history and development of naturopathy in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100011&lng=es&nrm=iso&tlng=es BACKGROUND: A huge growth in complementary and alternative medicine (CAM) took place in South Africa in the 1960s which paralleled what was happening in other parts of the western world. Naturopathy has been practised in South Africa for over 60 years, and the history of naturopathy is entwined with the broader history of CAM. No laws existed at that stage to regulate the curriculum, education and training of CAM practitioners. With the passage of time, various statutes were introduced which eventually led to changes in legislation and the establishment of a recognised training programme. Naturopathy became a legally regulated profession, the full history of which has never been documented. OBJECTIVE: This article explores the history of naturopathy in South Africa. METHOD: A two-phase qualitative research design was used, consisting of a document search and semi-structured interviews with key informants who were identified through a process of snowballing. Information collected from the naturopaths who participated in the interviews was triangulated with documentation uncovered in the archives of the Allied Health Professions Council of South Africa (AHPCSA) and other literature available. RESULTS: The result is a history of events which took place and reveals the effect of various legislations on the profession. CONCLUSION: Changes in the political system paved the way for changes in legislation which allowed for the registration and training of naturopathic practitioners. However, the lack of a functioning association and the small number of naturopathic graduates have hampered the growth of the profession, preventing it from becoming a significant contributor to the health care system. <![CDATA[<b>Methylphenidate and atomoxetine prescribing trends in children in the Western Cape Province of South Africa, 2005-2013</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100012&lng=es&nrm=iso&tlng=es BACKGROUND: There is paucity of data on methylphenidate and atomoxetine prescribing patterns in South African children. AIM: To describe the prescribing trends of these agents in children residing in the Western Cape Province. SETTING: South African private health secto.r METHODS: Longitudinal drug utilisation study on medicine claims data from 2005-2013, focussing on the number of patients and prescriptions per patient. RESULTS: The total number of patients increased by 29.5% from 2005 to 2013. The majority were boys (male:female ratio, 3.5:1), and between the ages of &gt; 6 and ≤12 years in 2005 and &gt;12 and ≤18 years in 2013. More than 75% of patients received methylphenidate or atomoxetine in the City of Cape Town Metropolitan municipality. Prescriptions for methylphenidate and atomoxetine increased by 45.5% overall from 2005 to 2013 (p < 0.001), with that for methylphenidate and atomoxetine increasing by 36.0% and 314.5%, respectively. The average number of annual methylphenidate prescriptions per patient increased from 3.96 ± 2.92 (95% CI, 3.69-4.23) in 2005 to 4.38 ± 2.85 (95% CI, 4.14-4.61) in 2013 (Cohen's d = 0.14) and for atomoxetine from 2.58 ± 1.86 (95% CI, 1.80-3.37) in 2005 to 4.85 ± 3.66 (95% CI, 3.84-5.86) in 2013 (Cohen's d = 0.62). CONCLUSION: Although the total number of patients and prescribing of methylphenidate and atomoxetine increased significantly from 2005 to 2013, a slight downward trend was observed in the mean number of prescriptions per patient per year from 2008 onwards. These prescribing patterns warrant further research. <![CDATA[<b>Experiences of partners of professional nurses venting traumatic information</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100013&lng=es&nrm=iso&tlng=es BACKGROUND: Professional nurses employed in trauma units encounter numerous stressors in their practice environment. They use different strategies to cope with this stress, including venting traumatic information to their partners and other family members. AIMS: To describe how partners of professional nurses cope with traumatic information being vented to them. METHODS: A qualitative research method with an interpretive descriptive inquiry design was used to explore, interpret and describe the coping experiences of the nurses' partners. Purposive sampling was used to select a total of 14 partners, but only ten participated in semi-structured interviews. Tesch's eight steps of open coding were used for data analysis. RESULTS: Four main themes were identified indicating adaptive and maladaptive coping skills, namely partners' experiences of traumatic information vented to them; partners' coping activities; reciprocal communication and relationship support between partners and nurses; and resilience of partners to deal with the nursing profession. CONCLUSION: Partners employed different ways to cope with traumatic information. It was essential for partners and nurses to be supported by nurses' practice environments and to develop resilience to fulfil reciprocal supportive roles in their relationships. <![CDATA[<b>Stressors and coping strategies among physiotherapy students: Towards an integrated support structure</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100014&lng=es&nrm=iso&tlng=es BACKGROUND: Stress is a major problem among university and, specifically, health care students, as it may influence academic performance and psychological well-being negatively. AIMS: To develop and implement a student support system based on the perceived stress, stressors and coping strategies of physiotherapy students. METHODS: A cross-sectional, descriptive study was undertaken, using a literature-based, self-compiled questionnaire and the 28-item General Health Questionnaire (GHQ-28). Over a period of three years, 207 third- and fourth-year physiotherapy students at a South African university were included. RESULTS: Psychological distress was experienced by 61.8%-71.2% of participants. During the 3 months prior to the study, 6% of participants received psychological or psychiatric help and 9% of participants used some form of psychiatric medication. The main stressors identified during clinical training were the suffering and death of patients, academic pressure and tension during interaction with personnel. Participants indicated that they mainly coped with these stressors by talking to someone such as a family member or a friend. CONCLUSIONS: Based on the findings of this study, a framework to identify and support students in pre-clinical and clinical training years was developed and implemented over five years. This proposed framework might positively contribute to the psychological well-being of health care students. <![CDATA[<b>Women's utilisation of prevention of mother-to-child transmission of human immunodeficiency virus services in Addis Ababa, Ethiopia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100015&lng=es&nrm=iso&tlng=es BACKGROUND: Human immunodeficiency virus (HIV) mother-to-child transmission (MTCT) can be prevented when HIV-positive pregnant women use effective prevention of mother-to-child transmission (PMTCT) of HIV services. Approximately 50% of HIV-positive pregnant women used free PMTCT services in Ethiopia. AIM: This study attempted to identify factors influencing women's utilisation of PMTCT services. Addressing such factors could enable more Ethiopian women to use PMTCT services. The study investigated whether women's utilisation of services was affected by socio-demographic issues, their partners' known HIV status, disclosure of their HIV-positive status, stigma and discrimination, and satisfaction with services. SETTING: Prenatal clinics in Addis Ababa, Ethiopia. METHODS: A quantitative, cross-sectional study design was used and 384 questionnaires were completed by women who used PMTCT services in Addis Ababa. RESULTS: No socio-demographic characteristic prevented women's utilisation of PMTCT services, nor did stigma, discrimination or disclosure of their HIV-positive status. Most respondents' partners with unknown HIV status did not know that the respondents used PMTCT services. Most women were satisfied with the PMTCT services. CONCLUSIONS: Prevention of mother-to-child transmission services should remain accessible to all HIV-positive women in Ethiopia. Concurrent HIV partner testing should be encouraged with appropriate counselling. HIV-positive pregnant women should be encouraged to disclose their status to their partners so that they need not use PMTCT services secretly. Patients' high levels of satisfaction with PMTCT services are a good indicator for rolling out PMTCT initiatives at other facilities. Future research should focus on HIV-positive pregnant women who do not use PMTCT services. <![CDATA[<b>A cooling cuff compared to a moist ice pack on radial artery blood flow and lumen diameter in healthy participants</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100016&lng=es&nrm=iso&tlng=es BACKGROUND: Cryotherapy is a favourable treatment for post-traumatic injuries in the acute stage because of its effect on inflammation and pain. A novel cooling cuff, which can be easily used and can be wrapped around the injured area that does not require freezing, has been developed. Its efficacy compared to traditional ice therapy has not been established. AIM: To establish the effect of a cooling cuff on radial artery blood flow and lumen diameter compared to moist ice. SETTING: Chiropractic clinic and radiographic laboratory. METHOD: A controlled laboratory pre-test post-test investigation assessed asymptomatic participants who were randomly allocated into a moist ice pack (n = 22) or the cooling cuff (n = 21) group. The intervention was placed on the participants forearm over the radial artery for 15 min. Data was collected by a qualified diagnostic radiographer using Doppler ultrasound. Data was analysed, using repeated measures analysis of variance to assess changes in blood flow and lumen diameter pre- and post-intervention. A p-value of less than 0.05 was considered significant. RESULTS: Both groups showed a significant decrease in radial artery blood flow (p < 0.001) after 15 min with no significant changes being observed in diameter size. No significant differences were observed between the groups for radial artery blood flow or diameter. CONCLUSION: The cooling cuff resulted in a similar effect on radial artery blood flow and lumen diameter as moist ice, indicating that patients and practitioners may utilise the cooling cuff in the acute phases of an injury to alter blood flow. <![CDATA[<b>Perceptions of caregivers regarding engagement with integrated management of chronic kidney disease patients in selected public hospitals of KwaZulu-Natal region, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100017&lng=es&nrm=iso&tlng=es BACKGROUND: Chronic kidney disease (CKD) patients rely on non-professional health care providers, namely caregivers to manage their long-term condition. Despite the growing literature on CKD patients, little is known about the perceptions of caregivers regarding integrated management of CKDAIM: The aim of the study was to explore the perceptions of caregivers with regard to integrated management of CKD patientsSETTING: The study took place in selected public hospitals of KwaZulu-Natal Province, South AfricaMETHOD: A qualitative case study design was used. A purposive sampling method was used to select the study participants. Data were collected through a semi-structured interview schedule developed from the literature. Data were analysed through thematic template approach using Health Belief Model constructsRESULTS: Hypertension and diabetes mellitus were risk factors that worsen progression of CKD. Unemployment, lifestyle changes and limited social interaction were revealed as negative effects of CKD. Caregivers were aware of consequences of non-engagement with integrated management. The revealed positive benefits of integrated management were mainly physiological and system-related. Barriers to engagement with integrated management were side effects of diet and haemodialysis, hot weather, unemployment, false perception of good health and shortage of kidneys for transplantCONCLUSION: Chronic kidney disease patients require caregivers support to help with necessary changes to cope and adapt with integrated management of the disease. These caregivers experience effects of CKD, consequences of non-engagement and barriers to integrated management. Identification of caregivers perceptions offers healthcare workers a better understanding and formulation of strategies that can offer adequate support to this population <![CDATA[<b>Perspectives of healthcare professionals of the neuropsychiatric side effects associated with efavirenz and its management</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100018&lng=es&nrm=iso&tlng=es BACKGROUND: Efavirenz is associated with neuropsychiatric side effects. The consequences of using efavirenz in human immunodeficiency virus (HIV)-positive patients with mental illness has not been conclusively established, the concern being that efavirenz may worsen the condition of an already mentally ill patient. The absence of guidelines and the lack of evidence for the use of efavirenz in this special population lead to uncertainty and, as a result, varying practices in the clinical settingAIM: To determine the experiences of healthcare professionals caring for mentally ill people living with HIV (PLWH) who are using efavirenz, the associated neuropsychiatric side effects and the management thereofSETTING: Eastern Cape, South AfricaMETHOD: A qualitative, descriptive, exploratory design was used to understand the phenomenon under study and to share the experiences of the participants. Semi-structured interviews were conducted. The data were analysed using thematic framework analysis and coded by the researcher as well as an independent coderRESULTS: There were conflicting feelings concerning the use of efavirenz in PLWH with active mental illnesses. Some healthcare professionals were willing to prescribe and use efavirenz whilst others were not. All participants indicated that further elucidation in the guidelines on the possible side effects associated with efavirenz and suggested management strategies would be usefulCONCLUSION: The expansion of the South African National Guidelines for the Treatment of HIV should include descriptions of the side effects caused by antiretrovirals and management strategies thereof to empower healthcare professionals to make informed decisions regarding patient care for mentally ill PLWH <![CDATA[<b>Psychosexual experiences of men following radiotherapy for prostate cancer in Johannesburg, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100019&lng=es&nrm=iso&tlng=es BACKGROUND: Radiation-induced erectile dysfunction (RiED) often occurs among patients diagnosed with prostate cancer (PCa) who undergo radiation treatment. However, sexual health care (SHC) is not a common practice in radiation oncology departments worldwide. Sexual health care in this context refers to a practice of integrating discussions around sexual well-being into the routine follow-up appointments of PCa patients to achieve better patient-centred care. Previous research identified unmet patient needs and mismatched expectations between patients and health care providers regarding SHC, but no such studies have been conducted in a South African settingAIM: The aim of this study was to explore and describe the psychosexual experiences of men following radiotherapy for PCa treated in JohannesburgSETTING: A qualitative phenomenology design with an interpretive research paradigm was employed, which allowed the study objectives to be achieved. Purposive sampling was used to recruit participants from a population of 305 patients. Data were transcribed verbatim and analysed in a step-by-step approachMETHOD: Data saturation was reached after completing semi-structured individual interviews (n = 9RESULTS: Feedback received from the participants was classified into three main themes: (1) their sexual experiences after PCa diagnosis, (2) the impact of losing sexual function on their relationships and (3) the lack of information from medical oncology staff regarding sexual health. Diverse psychosexual experiences and emotional reactions associated with erectile dysfunction before and after radiation therapy were identifiedCONCLUSION: The loss of sexual function had a detrimental impact on the men's quality of life, psychological well-being and intimate relationships. Participants shared unsatisfactory feelings about inconsistent and unmet SHC expectations in the radiation oncology clinic <![CDATA[<b>The role of triage to reduce waiting times in primary health care facilities in the North West province of South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100020&lng=es&nrm=iso&tlng=es BACKGROUND: Worldwide, patients visiting health care facilities in the public health care sector have to wait for attention from health care professionals. In South Africa, the Cape Triage Score system was implemented successfully in hospitals' emergency departments in the Cape Metropole. The effective utilisation of triage could improve the flow of primary health care (PHC) patients and direct the patients to the right health care professional immediatelyAIM: No literature could be traced on the implementation of triage in PHC facilities in South Africa. Consequently, a study addressing this issue could address this lack of information, reduce waiting times in PHC facilities and improve the quality of careSETTING: PHC facilities in a sub-district of the North West province of South AfricaMETHOD: A quantitative, exploratory, typical descriptive pre-test-post-test design was used. The study consisted of two phases. During phase 1, the waiting time survey checklist was used to determine the baseline waiting times. In phase 2, the Cape Triage Score system that triaged the patients and the waiting time survey checklist were usedRESULTS: Data were analysed using Cohen's effect sizes by comparing the total waiting times obtained in both phases with the waiting time survey checklist. Results indicated no reduction in the overall waiting time; however, there was a practical significance where triage was applied. Referral was much quicker to the correct health professional and to the hospitalsCONCLUSION: Although the results indicated no reduction in the overall waiting time of patients, structured support systems and triage at PHC facilities should be used to make referral quicker to the correct health professional and to the hospitals <![CDATA[<b>Evaluating the Integrated Management of Childhood Illness counselling skills of professional nurses in the North West Province of South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100021&lng=es&nrm=iso&tlng=es BACKGROUND: The Integrated Management of Childhood Illness (IMCI) strategy provides guidelines for supporting and improving the health system to reduce under-5 children's mortality rates. This strategy specifically assists professional nurses with the case management of children aged birth-5 yearsAIM: The purpose of this study was to investigate how professional nurses provided counselling to caregivers of under-5 children based on the IMCI strategy in Primary Health Care facilities of one district in the North West Province of South AfricaSETTING: Primary Health Care (PHC) facilities of one district in the North West ProvinceMETHOD: A quantitative, descriptive and observational design was used. Counselling provided by the professional nurses was observed and a checklist was completed. This IMCI counselling checklist was based on aspects in the counselling section of the Health Facility Survey, formulated according to the IMCI strategy's requirementsRESULTS: Counselling that focused on feeding, administration of medication and counselling skills used during the consultation were good. However, counselling of caregivers of children aged 13 months to 5 years could be improved and the caregivers' health status should also be addressedCONCLUSION: Counselling provided to caregivers of under-5 children regarding feeding, administering of medication and caregivers' health status used effective communication skills. However, technicalities of feeding such as lactation and nutritional guidance posed challenges <![CDATA[<b>Knowledge, attitudes and practices of nurses and pharmacists towards adverse drug reaction reporting in the South African private hospital sector</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100022&lng=es&nrm=iso&tlng=es BACKGROUND: Pharmacovigilance (PV) is an important tool in monitoring the quality, efficacy and safety of medicines, with spontaneous reporting being the mainstay system of reporting adverse drug reactions (ADRs) worldwide. ADRs are largely underreported in South Africa. AIM: This study aimed to evaluate the knowledge, attitudes and practices of pharmacists and nurses in the private hospital sector towards ADR reporting. SETTING: This study was conducted in six private hospitals and clinics within a single hospital group in Johannesburg, South Africa. METHOD: A cross-sectional survey was conducted amongst healthcare professionals using a structured multiple-choice questionnaire containing 20 close-ended questions. Both electronic and paper questionnaires were used to obtain as many responses as possible. RESULTS: A total of 233 healthcare professionals participated in the study. Of these, 78.5% were registered nurses and 21.5% were hospital pharmacists. Although three-quarters of participants believed ADR reporting to be important, most had received no previous PV training (76.2%) and did not know how to report an ADR (54.5%). The majority of participants (87.1%) believed that all ADRs should be reported, with 75.5% of participants believing they would report all ADRs they encountered in the future provided they had sufficient training and knowledge. The major factors discouraging participants from reporting was a lack of awareness with respect to the process of reporting as well as a lack of access to the ADR reporting form. CONCLUSION: The majority of participants require further training regarding ADR reporting. Although the knowledge of most participants was acceptable, the transition into practice needs to be improved. <![CDATA[<b>Validity and reliability of the Setswana translation of the Short Form-8 health-related quality of life health survey in adults</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100023&lng=es&nrm=iso&tlng=es BACKGROUND: The absence of culturally relevant measures in indigenous languages could pose a challenge to epidemiological studies on health-related quality of life (HRQoL) in developing nations AIM: To explore the feasibility and determine the validity and reliability of the Setswana translation of the HRQoL Short Form-8 (SF-8) among Setswana-speaking adults SETTING: Potchefstroom in the North West province. METHODS: Sixty healthy men (n = 26) and women (n = 34), aged 45.5 ± 9.3 years, completed a Setswana translation of the SF-8 questionnaire and the original English version twice, with a 4-week interval between completions. RESULTS: The Setswana SF-8 presented good concurrent validity with the Spearman's correlation coefficients (ρ) of 0.72 for role physical to 0.91 for social functioning. The Cronbach's alpha coefficients for the first and second measurements were 0.87 and 0.87, respectively, for the Setswana-translated SF-8 and 0.86 and 0.89 for the original English SF-8. The reliability coefficients were moderate for the mental health (ρ = 0.60), social functioning (ρ = 0.56) and role emotional (ρ = 0.50) domains, as well as the mental component summary (ρ = 0.50) and physical component summary (ρ = 0.45), but fair for the role physical (ρ = 0.43), body pain (ρ = 0.43), general health (ρ = 0.42), physical functioning (ρ = 0.41) and vitality (ρ = 0.38) domains on the translated Setswana version of the SF-8. CONCLUSION: The Setswana SF-8 version was feasible, acceptable and had acceptable concurrent validity and fair to moderate evidence of test-retest reliability for assessing HRQoL among adult Setswana-speaking community dwellers. <![CDATA[<b>Strengthening intellectually challenged adolescents' sense of self: An appreciative inquiry mixed-methods intervention</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100024&lng=es&nrm=iso&tlng=es BACKGROUND: Individuals with intellectual challenges may experience a sense of isolation within their families. How their families and friends react towards these challenges influences the formation of their identity and self-acceptance significantly. AIM: The aim of this research was to explore and describe how the sense of self of intellectually challenged adolescents could be strengthened within familial relationships and to evaluate the effectiveness of appreciative inquiry as an intervention approach. SETTING: The study was conducted with families at a school for children with intellectual disabilities in the Ekurhuleni Metropolitan Area, Northern Region of Gauteng, South Africa. METHODS: In an embedded mixed-method approach, a sample of 24 intellectually challenged adolescents and their families were selected, tested and interviewed. Quantitative data were collected using the BarOn Emotional Quotient Inventory (BarOn EQ-i:YV) on adolescents and the Family Environmental Scale (FES) on families in the experimental and control groups, before and after intervention. Qualitative data were gathered through an appreciative inquiry intervention and semi-structured interviews with adolescents in the experimental group. RESULTS: Although the quantitative findings were not statistically significant, the qualitative findings indicated that adolescents and family members experienced the sense of self of intellectually challenged adolescents positively, rather than as 'disabled'. The appreciative inquiry shows potential to strengthen intellectually challenged adolescents' sense of self in a supportive, positive family environment. CONCLUSION: The research is valuable in the way it highlights the importance of relational research in cases where quantitative research does not seem to be effective. <![CDATA[<b>The experiences of mine workers with cancer</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100025&lng=es&nrm=iso&tlng=es BACKGROUND: Cancer is a disease that instils a fear of death in the minds of most people. For South African mine workers, the fear of death is compounded by a fear of being unable to fulfil work obligations in an industry where employment is central to the miners' identity. AIM: The purpose of this research was to explore and describe the experiences of mine workers experiencing a cancer diagnosis requiring radiation therapy. SETTING: Mining towns in the Limpopo province, Thabazimbi and Lephalale. METHODS: A qualitative, descriptive and exploratory study design was utilised. The purposeful sample consisted of 11 mine workers receiving treatment at a radiotherapy centre in the North West province. Data were collected using an open-ended questionnaire and individual in-depth telephonic interviews. Data were analysed using open coding to identify themes. RESULTS: The themes identified were the emotional experience resulting from the diagnosis, changing family dynamics and information needs from radiotherapy professionals. The psychosocial support required by this group of patients is unique and radiation therapists need to provide wholistic support that is tailored to address the contextual needs of this group of patients. CONCLUSIONS: Mine workers often live far away from their family and are forced to face the cancer journey alone without family support. Oncology professionals, therefore, need to create supportive structures, including emotional and financial counselling, to ensure compliance with treatment protocols, thus facilitating a positive treatment outcome. <![CDATA[<b>Resilience enabling processes and posttraumatic growth outcomes in a group of women survivors of childhood sexual abuse</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100026&lng=es&nrm=iso&tlng=es BACKGROUND: This study forms part of a pilot project, aiming to evaluate the benefits of a programme entitled S2T denoting from Survivor to Thriver, which is a collaborative strengths-based group intervention programme for women survivors of childhood sexual abuse. The objective of the S2T is to enable resilience processes and facilitate posttraumatic growth outcomes. A theory of change was developed to explain how these objectives are met, it outlines the theoretical approach, mediators, primary and secondary outcomes. AIM: To explore emerging resilience processes and posttraumatic growth outcomes in women survivors of childhood sexual abuse after attending the S2T. SETTING: Data was collected during group treatment sessions of the S2T group intervention programme with women survivors of childhood sexual abuse. METHODS: A quasi-experimental, one group, pretest, posttest, time-delay design was used with eight purposively selected women with a history of childhood sexual abuse, using qualitative methods to evaluate the benefit of this intervention. Nine group treatment sessions and a delayed follow-up session were conducted. A visual participatory technique and transcriptions of group sessions were used to collect qualitative data. RESULTS: Qualitative thematic analysis revealed the following enabling resilience processes: group as healing vehicle of change; changing destructive to constructive rumination; coping strengths and meaning-making. Posttraumatic growth outcomes which evolved were: transforming wounded to healer; a changed life philosophy; excavated spirituality and re-briefing strengths through a posttrauma thriver identity. CONCLUSIONS: The themes suggest resilience processes and posttraumatic growth outcomes; a longitudinal study is recommended to establish effectiveness and inform treatment practice. <![CDATA[<b>Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100027&lng=es&nrm=iso&tlng=es BACKGROUND: Community service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions. AIM: The study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition. SETTING: The study was conducted at the training hospitals of the five districts in Limpopo province. METHOD: The researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch's eight-step process was used to analyse data. RESULTS: Results revealed that newly graduated midwives failed to meet the perceived expectations by experienced midwives; this was reflected in sub-themes: limited sense of independence, limited participation in task sharing and commitment and competence versus incompetence to patient care. CONCLUSION: The experienced midwives expected newly graduated midwives to function as professionals; unfortunately, they expressed disappointment as graduates did not meet their expectations. Newly graduated midwives lacked sense of independence, commitment to patient care and did not display ability in task sharing. <![CDATA[<b>The experiences of nurse educators in implementing evidence-based practice in teaching and learning</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100028&lng=es&nrm=iso&tlng=es BACKGROUND: Nurse educators have a vital role to mentor student nurses in relation to developing evidence-based practice (EBP) skills, accessing research products and participating in research projects. This requires more innovative teaching approaches that promote active participation, creativity and critical thinking in students such as online teaching and learning, accessing electronic resources, video conferencing and research-based teaching and learning. AIM: To determine the nurse educators' experiences in implementing EBP in teaching and learning, and to describe the importance and benefits of EBP teaching and learning to the nursing profession, especially for nurse educators and student nurses. SETTING: Two chosen campuses from Umgungundlovu Health District under the KwaZulu-Natal College of Nursing (KZNCN) and offering a 4-year R425 training programme. METHODS: Qualitative research design and methods were followed in conducting the study. A non-probability purposive sampling technique was used to access the sample of 12 nurse educators. Data were collected using semi-structured interviews, the interview guide, and the digital voice recorder. RESULTS: Data were analysed manually, following a content thematic approach and two themes emerged as challenges experienced by nurse educators with the implementation of EBP in teaching and learning and benefits and value of EBP in teaching and learning. Findings revealed that, although most of the nurse educators are supportive and displayed a positive attitude towards implementing EBP in teaching and learning, the level of knowledge and skills was questionable. This was coupled with a lack of motivation and commitment towards research. CONCLUSIONS: Evidence-based practice has an essential potential role to play through incorporating more practice-based evidence of nurse educators in teaching and learning implementation. The nurse educators should use EBP to ensure that student nurses receive high-quality nursing education. <![CDATA[<b> Acknowledgement to reviewers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362018000100029&lng=es&nrm=iso&tlng=es BACKGROUND: Nurse educators have a vital role to mentor student nurses in relation to developing evidence-based practice (EBP) skills, accessing research products and participating in research projects. This requires more innovative teaching approaches that promote active participation, creativity and critical thinking in students such as online teaching and learning, accessing electronic resources, video conferencing and research-based teaching and learning. AIM: To determine the nurse educators' experiences in implementing EBP in teaching and learning, and to describe the importance and benefits of EBP teaching and learning to the nursing profession, especially for nurse educators and student nurses. SETTING: Two chosen campuses from Umgungundlovu Health District under the KwaZulu-Natal College of Nursing (KZNCN) and offering a 4-year R425 training programme. METHODS: Qualitative research design and methods were followed in conducting the study. A non-probability purposive sampling technique was used to access the sample of 12 nurse educators. Data were collected using semi-structured interviews, the interview guide, and the digital voice recorder. RESULTS: Data were analysed manually, following a content thematic approach and two themes emerged as challenges experienced by nurse educators with the implementation of EBP in teaching and learning and benefits and value of EBP in teaching and learning. Findings revealed that, although most of the nurse educators are supportive and displayed a positive attitude towards implementing EBP in teaching and learning, the level of knowledge and skills was questionable. This was coupled with a lack of motivation and commitment towards research. CONCLUSIONS: Evidence-based practice has an essential potential role to play through incorporating more practice-based evidence of nurse educators in teaching and learning implementation. The nurse educators should use EBP to ensure that student nurses receive high-quality nursing education.