Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> vol. 20 num. 1 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Model of facilitation of emotional intelligence to promote wholeness of neophyte critical care nurses in South Africa</b>]]> This study was undertaken in order to develop a model of facilitation of emotional intelligence to promote wholeness in neophyte critical care nurses in South Africa. A theory-generative, explorative, descriptive, contextual research design was used. The model was developed utilising the four steps of theory generation as proposed by Dickoff, James and Wiedenbach (1968), Chinn and Kramer (2011) and Walker and Avant (2011). Step one dealt with the empirical phase in which the concepts were distilled. The facilitation of inherent affective and mental resourcefulness and resilience was the main concept of the model. Step two comprised the definition and classification of central and related concepts. Step three provides a description of the model. The model operates in three phases namely the dependent phase, partially dependent phase and the independent phase. Step four entailed the description of guidelines for operationalizing the model. During the three phases of the model a new nurse who starts to work in critical care moves from a latent ability to develop an inherent affective and mental resourcefulness and resilience to a state of developing an inherent affective and mental resourcefulness and resilience. This model provides a structured framework for the facilitation of emotional intelligence (EI) to promote wholeness in nurses who commence to work in critical care units.<hr/>Hierdie doel van hierdie studie was die ontwikkeling van 'n model van emosionele intelligensie vir die fasilitering van heelheid in kritiekesorgverpleegkundiges in Suid- Afrika. 'n Teoriegenerende, verkennende, beskrywende en kontekstuele navorsingsontwerp is gebruik. Die model was ontwikkel deur die vier stappe van teaorie generering te gebruik soos aanbeveel deur Dickoff, James en Wiedenbach (1968), en Walker en Avant (2011). Stap een handel oor die empiriese fase waar die belanglangste konsepte verkry is. Die fasilitering van inherente affektiewe en verstandelike vindingsrykheid en veerkragtigheid het die konsepte vir die model gevorm. Stap twee bestaan uit die definisie en klassifikasie van die sentral en verwante konsepte. Stap drie gee 'n beskrywing van die model. Die model bestaan uit drie fases naamlik die afhanklike fase, die gedeeltelike afhanklike fase en die onafhanklike fase. Gedurende die fases beweeg die pas gekwalifiseerde verpleegster van 'n sluimerende inherente affektiewe en verstandelike vindingsrykheid en veerkragtigheid na n person wat inherente affektiewe en verstandelike vindingsrykheid en veerkragtigheid ontwikkel het. Dit sal bydra to die fasilitering van heelheid by verpleegkundiges werksaam in kritiekesorgeenhede.Die vierde stap behels die beskrywing van riglyne vir die operasionalisering van die model. <![CDATA[<b>The health literacy needs of women living with HIV/AIDS</b>]]> Women in Sub-Saharan Africa are disproportionately affected by the virus and constitute 60% of the total HIV/AIDS infections in this region. Current recommendations endorse the involvement of people living with HIV in the development of programmes for people living with the virus. The purpose of the study was to explore and describe the health literacy needs of women living with HIV. The research design was qualitative, explorative, descriptive and contextual. After women living with HIV/AIDS were sampled purposively, semi-structured interviews were conducted with eight women and qualitative content analysis done. The findings revealed that the women expressed a need to increase their knowledge about HIV/AIDS. The knowledge they needed ranged from basic pathophysi-ology about HIV/AIDS, to the impact of HIV/AIDS on their health, to an awareness of the modes of HIV transmission and methods of protecting others from being infected. Other important health literacy needs related to self-care and correct antiretroviral use. A need for psychosocial skills was also identified in order for women to build and maintain their relationships. Recommendations were made for nursing practice, education and further research, based on these findings.<hr/>ABSTRAK Vroue in Sub-Sahara-Afrika word buite verhouding geraak deur die virus en vorm 60% van die totale MIV/VIGS - infeksies in hierdie streek. Huidige aanbevelings onderskryf die betrokkenheid van mense met MIV/VIGS in die ontwikkeling van MIV/VIGS programme vir mense met die siekte. Die doel van hierdie studie was om die gesondheid geletterdheid behoeftes van vroue met MIV te verken en te beskryf. Die navorsing was kwalitatief, verkennend, beskrywend en kontekstueel. Vroue met MIV/VIGS is doelgerig geidentifiseer en semi-gestruktureerde onderhoude is met agt vroue gevoer waarna kwalitatiewe inhoud-sanalise gedoen is. Die bevindinge het getoon dat die vroue 'n behoefte het om hul kennis oor MIV/VIGS uit te brei. Die kennis wat hulle benodig wissel van basiese patofisiologie oor MIV/VIGS, die impak van MIV/VIGS op hul gesondheid, 'n bewustheid van MIV-oordrag en maniere om naasbestaandes teen besmetting te beskerm. Ander belangrike gesondheid geletterdheid behoeftes het betrekking tot self-sorg en korrekte antiretrovirale gebruik. 'n Behoefte aan psigososiale vaardighede is ook gei'dentifiseer sodat vroue verhoudinge kan behou en bou. Aanbevelings gebaseer op hierdie bevindinge is vir die verpleegpraktyk, verpleegonderwys en verdere navorsing gemaak. <![CDATA[<b>Guidelines to facilitate self-care among older persons in South Africa</b>]]> BACKGROUND: The number of older persons is growing at an alarming rate, yet the South African healthcare sector is not giving this issue the required attention. Moreover, the healthcare sector serves four-fifths of the country's population and primary healthcare (PHC) facilities are overcrowded, and thus professional nurses are prevented from providing sufficient self-care health education to older persons AIM: To develop guidelines for the three role players - the public health sector, professional nurse and older person - to facilitate self-care among older persons in South Africa DESIGN: Quantitative, descriptive, explorative and contextual research design METHODS: A literature review followed by a self-care assessment of a sample of older persons using the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires which led to the identification of conclusions and self-care deficits. : Based on Menon's psychological health empowerment model, and from the conclusions and self-care deficits, nine self-care guidelines were developed for the public health sector, professional nurses and older persons CONCLUSION: This is the first systematic development of guidelines to facilitate self-care among older persons in South Africa. IMPLICATIONS FOR PRACTICE: The implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop. <![CDATA[<b>The BETA® nursing measure: Calibrating construct validity with Rasch analyses</b>]]> BACKGROUND: The BETA nursing measure has been introduced as a tool to routinely measure and monitor the outcomes of patients' activities of daily living in a restorative nursing care context. OBJECTIVES: To investigate the BETA's construct validity using the Rasch model with specific reference to the BETA's potential to be used as an interval scale providing metric or interval data. METHOD: A quantitative analytical design was followed using Rasch analyses whereby BETA raw data was collected from patients (n = 4235) receiving nursing care in 28 South African sub-acute and non-acute nursing facilities. The data was prepared for Rasch analyses and imported into WINSTEP® Software version (2010). Final results were shown by means of figures and graphs. RESULTS: A successful outcome was achieved by dividing the BETA into four subscales. In this process one of the original BETA items was omitted and seven other items required collapsing of their categories before the four subscales achieved a satisfactory fit to the Rasch model CONCLUSION: The four BETA subscales achieved "very well" to "excellent" levels of fit to the Rasch model. This finding thus creates an opportunity to convert the BETA's Likert qualities into an interval measure to calculate change in patients' activities of daily living metrically as a direct result of effective restorative nursing. <![CDATA[<b>Die impak van afwesige vaders op adolessente dogters se psigososiale welstand</b>]]> Daar is bevind dat baie kinders in Suid-Afrika sonder die betrokkenheid van 'n biologiese vader, grootword. Die afwesigheid van 'n ouer binne die gesinsisteem bring 'n vakuum in die ouerskapsrol mee en oefen 'n negatiewe invloed uit op 'n gesin se vermoë om doeltreffend te funksioneer. Met hierdie studie is die impak van afwesige vaders op die welstand van adolessente dogters ondersoek. Die studie is in twee fases verdeel. Tydens die eerste fase is semi-gestruktureerde onderhoude gevoer met ses dogters by wie die vader afwesig was. Die deelnemers se persoonlike menings van die impak wat hulle vaders se afwesigheid op hulle lewens gehad het, is in temas uiteengesit. Die kwalitatiewe data wat uit die onderhoude verkry is, is benut deurdat veranderlikes geïdentifiseer is wat in die tweede fase getoets kon word. Vir die tweede fase het 30 adolessente vraelyste ingevul. Hierdie bevindings is statisties weergegee. Die twee stelle bevindings is met mekaar vergelyk. Dit wil voorkom of die adolessente dogters 'n groot aantal onvervulde behoeftes het wat aan die afwesigheid van hulle vaders toegeskryf kan word. Hulle het behoefte daaraan om tyd saam met hulle vaders deur te bring en om 'n hegte band met hom op te bou. Die deelnemers het genoem dat hulle moeders beide die rol van moeder en vader vervul en deels vergoed vir die afwesigheid van hulle vaders. Die data wat deur hierdie studie ingesamel is, sal vaders help om 'n beter idee te kry van hulle waarde binne die gesinstruktuur.<hr/>It was found that many children in South Africa grow up without a biological father's involvement. The absence of a parent within a family system causes a vacuum in the parenthood role and has a negative influence on a family's ability to function efficiently. The impact of absent fathers on the well-being of adolescent girls is investigated in this study. The study was done in two phases. During the first phase semi-structured interviews were conducted with six girls where the father was absent. The participants' personal opinions of the impact their fathers' absence has on their lives were set out in themes. The qualitative data obtained from the interviews was used in that variables were identified that could be tested during the second phase. For the second phase, 30 adolescents completed questionnaires. These findings were reported in statistical form. The two sets of findings were compared with each other. It seems that the adolescent girls have a huge number of unfulfilled needs that can be ascribed to the absence or their fathers. They have a need for spending time with their fathers and to bond closely with him. The participants mentioned that their mothers fulfilled both the role as the mother and as the father and partly compensate for the absence or their fathers. The data collected through this study will assist fathers in forming a better idea of their value within the family structure. <![CDATA[<b>The development of a model for dealing with secondary traumatic stress in mental health workers in Rwanda</b>]]> INTRODUCTION: Mental health workers who listen to stories of fear, pain and distress of traumatised clients may develop deleterious emotional, cognitive and physical consequences (Cairns, 2007). This phenomenon has been called secondary traumatic stress (STS) (Perez, Jones, Englert, & Sachau, 2010). Rwanda is well-known for the 1994 genocide, with the death of hundreds of thousands of people in a planned campaign of violence. Numerous mental health workers operating in Rwanda were also victims of the violence and it has been suggested that there is a high level of STS in mental health workers in Rwanda (Iyamuremye & Brysiewicz, 2008). AIM: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda METHOD: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers) as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale) in these health workers. RESULTS: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS) was synthesised from these findings and includes preventive, evaluative and curative strategies to manage STS in mental health workers in Rwanda at the individual, social and organisational levels. CONCLUSION: The model will offer mental health professionals an effective framework for addressing the issue of STS. <![CDATA[<b>The experience of aggression by female teachers in the workplace</b>]]> South Africa is a country with exceptionally high levels of frustration and trauma. Research shows that a third of all people in South Africa are exposed to some kind of violence. This causes insecurity and fear, which creates high levels of stress. High stress levels fuels aggression in the workplace. It was observed that female teachers often experience aggression in the workplace. This has a negative effect on their overall sense of well-being as well as their mental health. A purposive sample was selected through two private schools in Gauteng, South Africa, and consisted of eight female teachers. Data was collected by means of in-depth phenomenological interviews, field notes, naive sketches and observation. One central question was posed to the purposefully selected participants: What is your experience of aggression in your workplace? Thematic coding was used to analyse the data. Three themes were identified: different perceptions influenced female teachers' experience of aggression; the pressure in the school system formed an integral part of the experience of aggression and the experienced effect of aggression on the female teachers.<hr/>Suid-Afrika is 'n land met hoë vlakke van frustrasie en trauma. Navorsing toon aan dat een derde van alle persone in Suid-Afrika al aan die een of ander vorm van geweld blootgestel was. Die gevolge hiervan is onsekerheid en vrees wat lei tot hoeë vlakke van stres. Hoë vlakke van stres bevorder dikwels aggressie in die werkplek. Dit is waargeneem dat vroulike onderwysers aggressie in die werkplek beleef. Dit het 'n negatiewe uitwerking op hulle algemene welsyn asook hulle geestesgesondheid. 'n Doelgerigte steekproef is getrek uit twee privaatskole in Gauteng, Suid-Afrika en het bestaan uit agt vroulike onderwysers. Data is met behulp van indiepte fenomenologiese onderhoude, veldnotas, na'iewe sketse en waarneming ingesamel. Een sentrale vraag is aan die doelgerig-gekose deelnemers gestel: Wat is jou ervaring van aggressie in jou werkplek? Tematiese kodering is gebruik om die data te analiseer. Drie temas is ge'identifiseer: verskillende persepsies het vroulike onderwysers se belewing van aggressie be'invloed, die druk in die skoolstelsel het 'n integrale deel van die belewing van aggressie gevorm en die beleefde uitwerking van aggressie op die vroulike onderwysers. <![CDATA[<b>The effect of lumbosacral manipulation on growing pains</b>]]> BACKGROUND: Growing pains are a frequent clinical presentation that continues to puzzle practitioners, with very little conclusive evidence in any medical field, including chiropractic. OBJECTIVE: The aim of this study was to determine whether lumbosacral manipulations have an effect on growing pain symptoms. METHODS: Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of 15 participants each. Group 1 received lumbosacral manipulations to restricted joints as determined by motion palpation, while Group 2 never received any professional intervention. Often parent(s)/guard-ian(s) of children who suffer from growing pains will rub the child's legs and offer verbal reassurance in an attempt to console their children. Parent(s)/guardian(s) of both groups were encouraged to continue to do this throughout the duration of the trial. Instructions were given to the parents so that the same rubbing technique and rubbing cream (aqueous cream) were used. Subjective changes were tracked using a pain diary that the parent(s)/ guardian(s) were asked to complete, a six-week post-study follow-up question regarding children's growing pains and the Oucher self-report pain scale. Objective measures consisted of pressure algometer readings of the tibialis anterior muscle belly. RESULTS: The statistical data was analysed using the Friedman test, Mann-Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, the group that received lumbosacral manipulations proved to show a quicker response to treatment; and the post-study follow-up of this same group showed markedly more positive feedback than the group that did not receive the treatment. These results highlighted the positive effects of chiropractic manipulation on growing pain symptoms. CONCLUSION: The results from this study, specifically the feedback from parent(s)/guardians(s) and the pain diaries, indicated that spinal manipulation is beneficial in the treatment of growing pains. The results also showed that other methods of treating growing pains, such as simple leg rubs, may also bring relief. <![CDATA[<b>An evaluation of the adequacy of pharmaceutical services for the provision of antiretroviral treatment in primary health care clinics</b>]]> BACKGROUND: With the introduction of nurse-initiated and -managed antiretroviral therapy (NIMART), new challenges have emerged with regard to the prescribing and dispensing of ART by nurses. One of the key challenges is ensuring adequate pharmaceutical services at PHC clinics. OBJECTIVE: The objective of the study was to evaluate the adequacy of pharmaceutical services for the provision of ART in PHC clinics. METHOD: A quantitative descriptive study was undertaken in 20 (43%) randomly selected, eligible clinics in the uMgungundlovu district of KwaZulu-Natal, South Africa. RESULTS: Clinics used allocated medicine rooms for storing medication, as there were no pharmacies. Problems identified were: insufficient storage space (50%; n = 10); inadequate security (40%; n = 8); poor air conditioning (20%; n = 4), and functional stock-outs of essential drugs (80%; n = 16). Professional nurses performed the tasks of managing drug supply and prescribing and dispensing medication as there were no pharmacists or pharmacist's assistants in these clinics. CONCLUSION: Human resource constraints necessitate professional nurses to manage drug supplies and to prescribe and dispense medication in resource-constrained PHC clinics. Clear guidelines tailored for PHC are needed to assist nurses in maintaining pharmaceutical service standards when ART services are decentralised. <![CDATA[<b>The value of the pre-hospital learning environment as part of the emergency nursing programme</b>]]> BACKGROUND: Professional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary. OBJECTIVE: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. METHODS: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of self-reported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews. The data was analysed using content analysis. RESULTS: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. CONCLUSION: The research findings support the value and continuation of utilising the pre-hospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme. <![CDATA[<b>Perceptions of nurse educators regarding the implementation of the occupational specific dispensation at a selected nursing college in Limpopo Province</b>]]> The aim of this study was to explore and describe the perceptions of nurses regarding the implementation of the occupation-specific dispensation (OSD) in a selected nursing college in Limpopo province. A qualitative approach was used with a purposive sampling method for the selection of 12 voluntary participants who had worked for more than five years and been subjected to the implementation of OSD. In-depth interviews were conducted and data analysed according to Tesch's method. The perceptions of nurse educators were shared through participants' responses to a central research question. Participants expressed different responses, both positive and negative. The findings of this study demonstrated: high expectations, unfair treatment in relation to the implementation, and reactions to introduction of OSD. Participants also identified envisaged ways of improving the situation through the identification of ways to correct the problems. This study recommended that management ensure that nurse educators' remuneration packages are competitive with those of similar professions in the clinical setting. Recognition of nurse educators' additional qualifications, long-service experiences and rural allowance reviews in nursing education should be taken into consideration urgently. <![CDATA[<b>Nurses' perceptions of facilitating genuineness in a nurse-patient relationship</b>]]> BACKGROUND: Genuineness was highlighted as an important concept when nurses' perceptions of facilitating a therapeutic relationship were assessed in a study conducted in private general hospital wards. Training courses are mainly professionally orientated and little attention is given to genuineness, which is underpinned by values and influenced by culture and self-awareness. Reflection on patients' feelings enables mindfulness in the nurse-patient relationship, but nurses often act on instinct or rely on learned knowledge and skills. Despite the increased emphasis on virtue ethics and honest disclosure, hope is offered but nurses are often not honest with themselves or in their response to patients. This poses a challenge when genuineness is facilitated. In this article, nurses' perceptions of facilitating genuineness will be discussed. METHOD: To assess nurses' genuineness, a quantitative, contextual, deductive and descriptive study was conducted. A purposive sample of nurses was taken from private general hospitals in Gauteng, South Africa. Nurses' (n = 181) perceptions of facilitating genuineness in a nurse-patient relationship were self-assessed on a five-point scale in a questionnaire. DATA ANALYSIS: Descriptive statistics and non-parametric statistical techniques were used. Specific hypotheses were tested to identify whether statistically significant differences in perceptions of facilitating genuineness existed between two or more groups. RESULTS: When groups were compared, statistically significant differences were identified in nurses' perceptions of facilitating genuineness with respect to age, years' experience as a nurse and qualifications. It is recommended that nurses' awareness of genuineness and its facilitation should involve learning through socialisation and self-awareness.