Scielo RSS <![CDATA[Curationis]]> http://www.scielo.org.za/rss.php?pid=2223-627920180001&lang=en vol. 41 num. 1 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Caesarean section deliveries: Experiences of mothers of midwifery care at a public hospital in Nelson Mandela Bay</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100001&lng=en&nrm=iso&tlng=en BACKGROUND: The rate of caesarean section deliveries has increased globally and mothers are faced with challenges of postoperative recovery and caring thereof. Midwives have a duty to assist these mothers to self-care. OBJECTIVE: The objective was to explore and describe experiences of post-caesarean section delivered mothers of midwifery care at a public hospital in Nelson Mandela Bay. METHODS: A qualitative, descriptive and explorative research design was used in the study. Data were collected from 11 purposively criterion-selected mothers who had a caesarean section delivery. One-on-one semi-structured interviews were conducted in the post-natal wards. Research ethics, namely autonomy, beneficence, justice and informed consent, were adopted in the study. All participants were informed of their right to withdraw from the study at any stage without penalties. Interviews were analysed using Tesch's method of data analysis RESULTS: Three main themes were identified as experiences of: diverse pain, physical limitation and frustration and health care services as different. CONCLUSION: Experiences of mothers following a caesarean section delivery with midwifery services at a public hospital in Nelson Mandela Bay were explored and described as diverse. A need for adequate pain management as well as assistance and breastfeeding support to mothers following caesarean delivery was identified as crucial to promote a good mother-to-child relationship. <![CDATA[<b>Conceptualisation of African primal health care within mental health care</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100002&lng=en&nrm=iso&tlng=en BACKGROUND: It is believed by western education systems that the first contact should be with the nurse in primary health care. However, it is not the case. Therefore, the researcher attempts to correct this misconception by conceptualising the correct beginning of health seeking behaviour in an indigenous African community, namely African Primal Health Care (APHC). 'Primal' was coined during a colloquium by Dr Mbulawa and Seboka team members; however no formal conceptualisation took place, only operational definition. Due to the study scope, conceptualisation is narrowed to mental health, but this concept is applicable in the broader health context. The research purpose was to contribute to the body of indigenous knowledge systems to advocate towards co-existence of primal health care and mental health care. AIM: Formulate APHC within a mental health care context. OBJECTIVES: To explore philosophical grounding of APHC and describe epistemology of APHC. To analyse and crystallise the exploration to establish understanding within mental health and conceptualise APHC within mental health care to enhance co-existence. METHODOLOGY: Narrative synthesis, concept analysis (qualitative design). Lekgotla was used as a method of data collection and data were analysed using Leedy and Ormrod's five steps of data analysis. RESULTS: APHC is a health care system that existed in Africa prior to the introduction of the western health care system. It is based on the African belief system and practices. The practices come from the community, for the community and are authenticated by the community. APHC uses a holistic approach and the family and community are involved in the healing process. <![CDATA[<b>A middle-range model for improving quality of nursing education in Malawi</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100003&lng=en&nrm=iso&tlng=en BACKGROUND: Despite a global consensus that nurses and midwives constitute the majority and are a backbone of any country's health workforce system, productive capacity of training institutions remains low and still needs more guidance. This study aimed at developing a middle-range model to guide efforts in nursing education improvements. OBJECTIVE: To explore challenges facing nursing education in Malawi and to describe efforts that are being put in place to improve nursing education and the process of development of a model to improve nursing education in Malawi. METHOD: The study used a qualitative descriptive design. A panel discussion with eight nursing education and practice experts was conducted guided by core concepts derived from an analysis of research report from a national nursing education conference. Two focus group discussions during two quarterly review meetings engaged nurse educators, practitioners and clinical preceptors to fill gaps from data obtained from a panel discussion. A qualitative abductive analysis approach was used for the development of the model. RESULTS: Transforming and scaling up of nursing education emerged as the main concept of the model with nursing education context, academic practice partnership, regulation, competent graduate and nursing workforce as sub concepts. Key main strategies in the model included curriculum reforms, regulation, transformative learning, provision of infrastructure and resources and capacity building. CONCLUSION: The model can be used to prioritise nursing education intervention aimed at improving quality of nursing education in Malawi and other similar settings. <![CDATA[<b>The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100004&lng=en&nrm=iso&tlng=en BACKGROUND: The current roles and capacity of community health workers (CHWs) in the management and control of non-communicable diseases (NCDs) remain poorly understood. OBJECTIVES: To assess CHWs' current roles, training and knowledge about diabetes and hypertension in Khayelitsha, Cape Town. METHODS: A cross-sectional study of 150 CHWs from two non-governmental organisations contracted to provide NCD care as part of a comprehensive package of services was conducted. An interviewer-administered closed-ended questionnaire was used to determine the roles, training, in-service support, knowledge and presence of NCDs. Descriptive analyses of these domains and multivariate analyses of the factors associated with CHWs' knowledge of hypertension and diabetes were conducted. RESULTS: The vast majority (96%) of CHWs were female, with a mean age of 35 years; 88% had some secondary schooling and 53% had been employed as CHWs for 4 years or more. Nearly half (47%) reported having an NCD. CHWs' roles in NCDs included the delivery of medication, providing advice and physical assessment. Only 52% of CHWs reported some formal NCD-related training, while less than half of the trained CHWs (n = 35; 44%) had received follow-up refresher training. CHWs' knowledge of diabetes and hypertension was poor. In the multivariate analyses, higher knowledge scores were associated with having an NCD and frequency of supervisory contact (≥1 per month). CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to be successful. The potential of peer education as a complementary mechanism to formal training needs as well as support and supervision in the workplace requires further exploration. <![CDATA[<b>Barriers to tuberculosis and human immunodeficiency virus treatment guidelines adherence among nurses initiating and managing anti-retroviral therapy in KwaZulu-Natal and North West provinces</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100005&lng=en&nrm=iso&tlng=en BACKGROUND: Nurses, as front-line care providers in the South Africa's health care system, are called upon to deliver integrated interventions for tuberculosis and human immunodeficiency virus (TB and HIV) including nurse-initiated management of anti-retroviral therapy (NIMART) and anti-TB treatment. Adherence to treatment guidelines and factors associated with non-adherence to treatment guidelines among nurses remain under explored. PURPOSE: To explore and describe barriers to treatment guidelines adherence among nurses initiating and managing anti-retroviral therapy and anti-TB treatment in KwaZulu-Natal and North West provinces. DESIGN: This study employed a qualitative exploratory descriptive design. METHODS: Four semi-structured focus group interviews were conducted during 2014 each consisting of four to eight NIMART trained nurses. Audiotaped interviews were transcribed verbatim and analysed using Atlas T.I. software. FINDINGS: During data analysis, two themes emerged: (1) NIMART trained nurses' distress about TB and HIV guidelines adherence that is inclusive of lack of agreement with guidelines, poor motivation to implement guidelines, poor clinical support and supervision, resistance to change, insufficient knowledge or lack of awareness and (2) exterior factors inhibiting nurses' adherence to treatment guidelines which incorporated organisational factors, guidelines-related factors and patient-related factors. CONCLUSION: This qualitative study identified that nurses have substantial concerns over guideline adherence. If NIMART trained nurses' barriers inhibiting adherence to treatment guidelines cannot be remedied, patient outcomes may suffer and South Africa will struggle to meet the 90-90-90 targets. <![CDATA[<b>A model to facilitate the mental health of psychiatric nurses in a forensic unit to manage mental health care users' hostile behaviour constructively</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100006&lng=en&nrm=iso&tlng=en BACKGROUND: Hostile behaviour by mental health care users (MHCUs) is prevalent in forensic units in South Africa, and this causes service providers distress and burnout. Psychiatric nurses (PNs) find it difficult to render quality care to MHCUs who are threatening them and also challenging their authority in a forensic unit. Forensic mental health care practitioners may be challenged to engage authentically with MHCUs who constitute a risk to their personal safety or who have committed acts the practitioner finds morally disturbing. There is a need to facilitate the mental health of PNs in a forensic unit to manage hostile behaviour constructively. OBJECTIVE: The objective of this article is to describe the process that was followed in developing, implementing and evaluating a model that could be used as a framework of reference to facilitate the mental health of PNs in a forensic unit to manage hostile behaviour constructively. METHOD: A theory-generative, qualitative, exploratory descriptive and contextual study design was used to develop the model. The steps of the process entailed the identification of the central concept, the definition of the central concept and other essential criteria and the classification of the central and related concepts. The model was then described and evaluated. RESULTS: The central concept was identified as the 'facilitation of empowerment of PNs to manage hostility in a constructive manner', defined, classified and then described and evaluated. CONCLUSION: The model as framework of reference could assist PNs in managing hostility in a forensic unit constructively. <![CDATA[<b>Worker knowledge of occupational legislation and related health and safety benefits</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100007&lng=en&nrm=iso&tlng=en BACKGROUND: Environmental hazards such as fumes, gases, poor ventilation and extreme temperatures might lead to occupational illnesses and injuries. To protect workers from potential occupational health and safety risks, the government has promulgated occupational legislation that must be implemented in work settings. OBJECTIVES: The objective of this study was to explore the knowledge of workers about occupational legislation and its benefits for their health and safety. The aim was to make recommendations that would be implemented to improve the knowledge and compliance with occupational legislation as advised by the occupational health nurse. METHODS: A quantitative approach was used for this study. One hundred and ten respondents were sampled from an accessible population of 1590 workers. A self-administered questionnaire was used for gathering data. Data were analysed through descriptive analysis using Statistical Package for Social Sciences. RESULTS: Research findings indicated that only 18 (16.36%) respondents were knowledgeable about occupational legislation. Eighty-two (75.54%) respondents were unable to mention even one occupational act by name. Respondents mentioned five benefits of occupational legislation for the health and safety of workers. These benefits were that legislation ensured safety, gave rights to workers, ensured compensation for occupational injuries and illnesses, and provided guidance in the prevention of occupational injuries and illnesses. CONCLUSION: Most respondents (75.54%) were found not to be knowledgeable about occupational legislation. The positive finding was that respondents knew the benefits of occupational legislation. To improve the respondents' knowledge about legislation, five recommendations are made by the researcher. <![CDATA[<b>The relationship between resilience and empowering leader behaviour of nurse managers in the mining healthcare sector</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100008&lng=en&nrm=iso&tlng=en BACKGROUND: The South African mining healthcare sector faces injuries, illnesses including HIV and AIDS and high staff turnover rates. In this sector, nurse managers should create an optimal environment for providing nursing care by motivating, influencing and empowering nurses. OBJECTIVES: This study aimed to investigate the relationship between nurse managers' resilience and empowering leader behaviour in this sector. METHOD: The study employed a quantitative, descriptive and correlational design. The research population comprised 31 nurse managers, 101 professional nurses, 79 enrolled nurses and 79 enrolled nursing auxiliaries who participated in the study. Two questionnaires were used as data collection methods, namely Wagnild and Young's Resilience Scale Questionnaire to investigate the resilience of nurse managers and the Empowering Leadership Questionnaire to measure empowering leader behaviour of the nurses supervised by a particular nurse manager. RESULTS: Out of 31 nurse managers, 8 had a low level, 19 had a moderate level and 4 had a high level of resilience. According to Hoteling's t-test the nurse managers in the low resilience group displayed lower empowering leader behaviour as perceived by their team members than those in the high resilience group in terms of the five factors included in the Empowerment Leadership Questionnaire. CONCLUSION: Respondents with high resilience scores tended to have higher leader empowering behaviour. Recommendations include the strengthening of nurse managers' resilience through workshops and reflection practices, debriefing and performance feedback sessions. <![CDATA[<b>Northern Ghana final-year nurses' attitudes towards nursing and remaining post qualification</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100009&lng=en&nrm=iso&tlng=en BACKGROUND: Recruitment and retention concerns nursing globally, including Ghana, as the country attempts to meet health demands. A link exists between nursing students' attitudes towards nursing and decisions to enter, remain in or withdraw from the profession. OBJECTIVES: To describe northern Ghana final-year student nurses' current attitudes towards nursing and remaining in nursing post qualification. METHOD: Non-experimental quantitative descriptive design used convenient sampling targeting final third-year student nurses (n = 80) studying towards a Diploma in Registered General Nursing in a northern Ghana college (N = 220). Data were gathered using the attitude dimension of a self-administered questionnaire, developed by Al-Omar. RESULTS: The response rate was 87.5% (n = 70). Respondents were 20-30 years of age, more men and predominantly from urban areas. The mean attitude dimension score (range 10-50) was 35.41 (SD 4.03) with no skewness (0.37); mean of single-item question about intention to stay in nursing was 3.68 (SD 1.14) with negative skewness (-0.92). Male and urban respondents' attitudes were more positive than those of female respondents. No association was found between attitude score and demographics or intention to stay in nursing, but significant association was found between gender and habitation and attitude categories. Medium positive correlation existed between intent to stay in nursing and attitude score. Pay, travel opportunities and nursing being a challenging career attracted unfavourable attitudes. CONCLUSION: Ghanaian male student nurses' attitudes are non-typical of general stereotypes held of nurses and gender, suggesting increased recruitment of male nurses. Demographic variables hold a small amount of value in the development of attitudes in Ghanaian nurses. <![CDATA[<b>Individual determinants associated with utilisation of sexual and reproductive health care services for HIV and AIDS prevention by male adolescents</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100010&lng=en&nrm=iso&tlng=en BACKGROUND: Adolescent sexual and reproductive health is one of the essential health care programmes in the world. However, adolescents still face numerous challenges in the area of sexual and reproductive health, which hinder their utilisation of available Sexual and Reproductive HealthCare Services (SRHCS). Male adolescents face further obstacles in accessing and utilising sexual reproductive health services owing to the influence of social constructions of masculinity, which has a bearing on how they view sexual and reproductive health services and their use. OBJECTIVES: The aim of this study was to investigate individual determinants associated with utilisation of SRHCS for HIV and AIDS prevention by male adolescents. METHOD: An exploratory, descriptive and contextual qualitative design was used and semi-structured interviews with 20 purposively selected male adolescents aged 18-24 years living in the South African seat of government were conducted. Data were analysed using Tesch's approach of data analysis. RESULTS: Knowledge of existing services was described as a significant individual determinant of utilisation of SRHCS. This was linked to the quality of SRHCS and violation of human rights of male adolescents CONCLUSION: The study recommends the development of a strategy that will enhance and promote the utilisation of SRHCS by male adolescents. <![CDATA[<b>Frequency and reasons for missed appointments of outpatient mental health care users in the uMgungundlovu District</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100011&lng=en&nrm=iso&tlng=en BACKGROUND: Over the years, there has been a rapid growth in the use of mobile technology which has been proven to increase treatment adherence. Short message services may improve service delivery through appointment reminders and improve communication between health care workers and patients. Missed appointments are becoming common amongst mental health care users, and this has a significant economic burden on mental health symptoms. OBJECTIVES: The aim of the study was to determine the frequency and reasons for missed appointments of outpatient mental health care users for their follow-up care in the uMgungundlovu District METHOD: This study used a quantitative survey. A non-probability convenient sampling method was used to select 182 participants at the psychiatric clinic.s RESULTS: Of the 182 participants, results of the study indicated that n = 84 (46.2%) respondents had missed their appointment at some stage. Of the n = 84 (46.2%) respondents who had missed appointments, n = 28 (33.3%) had missed their appointment once, and n = 45 (53.6%) had missed their appointment 2-3 times. Most common reasons for missed appointments included mental health care users forgetting (n = 58; 69%), work commitments (n = 14; 16.7%), no transportation (n = 4; 4.8%) and financial constraints (n = 5; 6%). CONCLUSION: The main reasons for missed appointments that were identified included forgetfulness, work commitments, lack of transportation and financial constraints. A significant number of participants (53.6%) had missed their appointments 2-3 times. <![CDATA[<b>Integration experiences of student and qualified nurses with disabilities who graduated from selected KwaZulu-Natal nursing education institutions: An exploratory case study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100012&lng=en&nrm=iso&tlng=en BACKGROUND: Despite the introduction of the Disability Policy Guidelines in South Africa (SA), student nurses who have disabilities (SNWDs) are still habitually and effectively excluded from nurse training programmes, and hence from the nursing profession. Yet SNWD may be able to offer a unique perspective. OBJECTIVES: To explore and describe the integration experiences of both student and qualified nurses with disabilities who graduated from selected KwaZulu-Natal nursing education institutions (NEIs). METHOD: A concurrent mixed-method design based on multiple embedded case studies served as the primary data collection instrument in this paper. The researcher initially conducted a survey of all the private NEIs to determine which had experienced training SNWDs; 3 cases and 10 embedded cases were selected, using non-probability purposive sampling. Individual interviews were conducted with students and qualified nurses with who have a disability (n = 10) who had graduated from NEIs. RESULTS: The findings of the study indicated that, largely, private NEIs are paving the way for integrating SNWDs; however, there are still some gaps in meeting the needs of these students. Despite strong legislative policies, an inclusive and enabling teaching and learning environment for SNWDs in nurse training remains largely absent. CONCLUSION: The study recommends that NEIs develop policy guidelines for integrating SNWDs in nursing education programmes promoting an inclusive nursing education for SNWDs. The introduction of a disability liaison to assist SNWDs by liaising between key stakeholders and, perhaps, addressing many of the challenges that SNWDs experience in the clinical facilities where nursing personnel are unaware of their disability. <![CDATA[<b>Factors influencing enrolled nursing students' academic performance at a selected private nursing education institution in KwaZulu-Natal</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100013&lng=en&nrm=iso&tlng=en BACKGROUND: The success of any educational institution is measured by its academic performance or how well students meet the standards set out. Currently, nursing students' academic failure is a phenomenon of growing international interest because of its economic impact and its negative effects on the availability of future nurses in different health care systems. Factors identified as influencing the academic performance of students include the socio-economic background of parents or guardians, lecturer-student relationships, academic support services, demographic factors, quality of nurse educators, availability of facilities in the school, the language of instruction and level of entry qualifications of students. OBJECTIVES: The purpose of this study was to describe the perceptions of enrolled student nurses on factors influencing their academic performance in a private nursing school in KwaZulu-Natal, South Africa. METHOD: Data were collected from 100 respondents using an adapted instrument related to the factors believed to influence students' academic performance. RESULTS: The results showed that parental involvement in education, good and supportive relationships between nurse educators and students, classroom computer technological gadgets, internet connection and adequate learning facilities were perceived as fostering better academic performance of students. In contrast, poor family background, use of English language for classroom instruction as well as negative peer group influences were leading to poor academic performance. CONCLUSION: Nursing institutions should, therefore, select students with higher-level entry qualifications, early identify at-risk students, recruit more qualified nurse educators and upgrade their facilities. <![CDATA[<b>Record-keeping: Challenges experienced by nurses in selected public hospitals</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100014&lng=en&nrm=iso&tlng=en BACKGROUND: Patients' records provide a trace of care processes that have occurred and are further used as communication amongst nurses for continued management of patients. Nurses have the responsibility to ensure that records are accurate and complete in order to effectively manage their patients. In hospitals, nurses have to record a wide range of information in the patient's records and this leads to increased workload on the part of nurses that compromises accurate record-keeping. OBJECTIVES: The purpose of this study was to explore and describe the challenges experienced by nurses with regard to record-keeping at selected public hospitals in the Vhembe district, Limpopo Province, South Africa. METHOD: A qualitative, explorative and descriptive research design was used. Nurses working in selected public hospitals were purposively selected and semi-structured interviews were conducted until data saturation was reached. Data were analysed using the Tesch's open-coding method. RESULTS: Nurses working in public hospitals experience record-keeping as a challenging activity owing to a variety of challenges which include lack of time to complete the records, increased patients' admission and shortage of recording material. CONCLUSION: Record-keeping is not done properly which is problematic, and it is recommended that there should be continuous training, monitoring and evaluation of nurses on record-keeping issues, supply of adequate recording materials and proper time management amongst nurses to improve record-keeping challenges. The need for comprehensive record-keeping remains fundamental in public hospitals in order to improve patient care. <![CDATA[<b>Support of students by academics in a nursing foundation programme at a university in the Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100015&lng=en&nrm=iso&tlng=en BACKGROUND: Owing to the inadequate schooling system and the under-preparedness of students in South African high schools, Higher Education Institutions are faced with students who do not meet the minimum criteria for acceptance into a mainstream programme and need support from an extended foundation programme. OBJECTIVES: The study described the support of students by lecturers in an extended 5-year nursing foundation programme. METHOD: A qualitative, exploratory and descriptive design was applied. Purposive sampling was conducted, and eight nursing students who completed the foundation year took part in semi-structured individual interviews. Each interview took around 30 min and was digitally recorded. Data were transcribed verbatim and analysed using open coding. Ethical principles and trustworthiness were maintained throughout the study. RESULTS: The findings of this study indicated that experiences varied on a foundation programme. Participants expressed support in a nurturing environment in which the lecturers were open and approachable with a positive attitude. Lecturers could support students by being caring and advising in learning methods around the programme. Lecturers could focus on the method of peer support which should be encouraged beyond the programme so as to provide a sense of camaraderie amongst students. CONCLUSION: Data revealed that support of lecturers in a foundation programme needs creative methods to make the learning environment nurturing for students. This provides for students from diverse backgrounds the opportunity to prepare for their studies at a university level. Insights gained from this study, which highlight the importance of supporting foundation students, could benefit all nurse educators offering foundation programmes. <![CDATA[<b>Analysis of self-evaluated ethical competence of midwifery students at a selected nursing college in the Free State</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792018000100016&lng=en&nrm=iso&tlng=en BACKGROUND: It is imperative to know whether the students who have undergone a specific training perceive themselves as confident and competent in handling ethical dilemmas, in the face of contemporary ethical challenges. Such evaluation is significant especially for nursing and midwifery students who have undergone training that stipulates adherence to a code of ethics and professional norms. At present, such knowledge is limited, and this has an impact for ethics education. OBJECTIVES: The article aims to describe the self-evaluated ethical competence of midwifery students and to contrast the findings to the content of the ethics instruction received. Based on outcomes, the article aims to convey the claim to nursing institutions that current strategies that rely on teaching nursing ethics without appraising the context of a situation are ineffective in fostering ethical competence amongst students. METHOD: This study made use of a set of self-reflection reports in which the midwifery nursing students narrated their experiences in handling ethical issues. RESULTS: Analysis of the self-reflective reports revealed that one of the three dimensions of ethical competence was limited. There was evidence of moral perception, moral action and substandard moral reasoning. The principles that were mostly referred to within the narratives were autonomy and beneficence. CONCLUSION: The findings support the argument that teaching principlism and enforcing a code of ethics without contextualising it coerces the student to conform without questioning their beliefs. Thus, ethical competence amongst the midwifery students may be described in terms of compliance to principles with limited reflection on the situation as a whole.