Scielo RSS <![CDATA[Curationis]]> http://www.scielo.org.za/rss.php?pid=2223-627920170001&lang=pt vol. 40 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Lived experiences of parents of premature babies in the intensive care unit in a private hospital in Johannesburg, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100001&lng=pt&nrm=iso&tlng=pt BACKGROUND: Many of the 15 million premature babies born worldwide every year survive because of advanced medical interventions. Their parents have intense experiences when their babies are in the intensive care unit (ICU), and these have an impact on their thoughts, feelings and relationships, including their relationships with their premature babies. OBJECTIVES: The aim of the study was to explore and describe the lived experiences of parents of premature babies in an ICU. METHOD: Research design was qualitative, exploratory, descriptive and contextual. A purposive sample of parents with premature babies in an ICU in a private hospital in Johannesburg Gauteng in South Africa was used. Eight parents, four mothers and four fathers, married and either Afrikaans or English-speaking, were included in the study. Data were collected by conducting in-depth phenomenological interviews with them and making use of field notes. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, non-maleficence and justice were adhered to throughout the research process. RESULTS: Thematic analyses were utilised to analyse the data. Two themes in the experiences of parents with premature babies in ICU became apparent. Parents experienced thoughts, emotions and hope while their premature babies were in the ICU as well as challenges in their relationships and these challenges influenced their experiences. RECOMMENDATIONS: Mindfulness of intensive care nurses should be facilitated so that intensive care nurses can promote the mental health of parents with premature babies in the ICU. CONCLUSION: Parents with premature babies in the ICU have thoughts and emotional experiences which include hope and they affect parents' relationships. <![CDATA[<b>A profile of perceived stress factors among nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100002&lng=pt&nrm=iso&tlng=pt INTRODUCTION: Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. OBJECTIVES: To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC). METHODS: This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors. The data were summarised by frequencies and percentages (categorical variables) and means or percentiles (numerical variables). RESULTS: Most participants were aged between 46 and 55 (41.2%), female (93.2%) and black (93.2%), and 76.7% had children or dependant minors. The main stressors among participants were pressure providing financially for their children and dependant minors (71.2%), caring for them (39.4%) and fearing them moving away (25.8%). Occupational stressors included high workload (66.3%), lack of decision-making by superiors (58.1%), underpayment (53.5%), endangerment of physical health (52.3%) and safety (50.0%), working hours (51.2%), pressure of expectations from superiors (48.8%), uncertainty of employment (48.8%), work responsibilities (47.7%) and perceiving that skills and training were not appreciated. They experienced stress regarding health issues such as hyper- and hypotension (35.3%). Because of stress 34.5% of participants took leave, 34.5% developed depression and 14.3% had panic attacks. CONCLUSION: Most of the respondents experienced personal and occupational stress that influenced their health, which poses serious challenges for the management of the FSPC. Security should be upgraded, medical and psychological support for the staff and care facilities for their dependants should be provided, and financial problems experienced by these staff members should be addressed. The workload of the nursing staff at FSPC needs urgent attention. This can be done by means of a workforce analysis to determine minimum staffing levels for nursing. <![CDATA[<b>Nurses' knowledge, attitudes and practices regarding evidence-based practice in the prevention of mother-to-child transmission of HIV programme in Malawi</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100003&lng=pt&nrm=iso&tlng=pt BACKGROUND: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission. OBJECTIVES: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi. METHODS: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software. RESULTS: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses. CONCLUSION: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted. <![CDATA[<b>Experiences of patients with hypertension at primary health care in facilitating own lifestyle change of regular physical exercise</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100004&lng=pt&nrm=iso&tlng=pt BACKGROUND: Regular physical exercise is one of the lifestyle modification general measures to control the blood pressure (BP) of patients with hypertension. Globally, hypertension is considered a non-communicable disease (NCD), as well as a chronic condition of lifestyle, that contributes to the mortality rate caused by complications of cardiovascular burden of diseases. In South Africa, NCDs account for nearly 40% of adult deaths, with a high prevalence among black people in urban areas such as Soweto. The first step in treating hypertension is lifestyle modification, referred to in this study as health-promoting lifestyle change measures. Despite the positive benefits of regular physical exercise in controlling hypertension, in 2014, only 10% of men and 18% of women with hypertension had their BP controlled to a level that would eliminate the risk of cardiovascular disease (CVD) complications. OBJECTIVES: The aim of this article is to present the experiences of patients with hypertension regarding the facilitation of their own health-promoting lifestyle change measure of regular physical exercise. METHOD: A qualitative, exploratory, descriptive and contextual research design was used. The accessible population of patients with hypertension at three primary health care (PHC) clinics in Soweto was targeted and purposefully sampled. Focus group and individual interviews were conducted to collect data till data saturation occurred. Tesch's open-coding method of data analysis was used. RESULTS AND CONCLUSIONS: Findings show that participants experienced poor self-care due to poor self-efficacy, demonstrated by not engaging in regular physical exercise, which in turn, resulted in uncontrolled BP and cardiovascular complications from hypertension. More should be done to educate, motivate and empower patients with the necessary knowledge, skills and the values in facilitating their own regular physical exercise in order to improve their own quality of health. <![CDATA[<b>Prevalence of adolescent obesity at a high school in the City of Tshwane</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100005&lng=pt&nrm=iso&tlng=pt BACKGROUND: Obesity has been reported to be on the rise in the world and South Africa is no exception. In recent years obesity has been reported to contribute to the increasing number of people with hypertension and diabetes mellitus. Africa has the fastest growing number of overweight and obese adolescents, with indications that in 2010, it had more than doubled since 1990. Some people might perceive being overweight as being round and healthy which might contribute to the increased rate of obesity in South Africa. Physical and psychological changes that occur during adolescence can also be observed earlier during the preteen years (ages 9-12 years). During this time, peer groups and external appearance are of importance. Physical changes, such as obesity, might be perceived negatively by adolescents, affecting their self-esteem. OBJECTIVES: The purpose of the study was to determine the prevalence of adolescent obesity at a high school in the City of Tshwane. METHOD: A cross-sectional survey was conducted. Stratified random sampling was used and data were collected from 30% of the total population as recommended by the statistician. Data analysis was performed using descriptive analysis. Validity and reliability were ensured through calibrating the weight-monitoring scale and the measuring tape, which are collection tools. RESULTS: The results identified the prevalence of adolescent obesity at 8.57%. There is evidence of abdominal obesity and waist-hip ratio ≥ 1. The results show that there is a steady increase in obesity levels among adolescents. The poor response of parents was observed and could demonstrate the need to form stronger partnerships for weight reduction interventions. CONCLUSION: Evidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified. <![CDATA[<b>Professional nurses' perceptions and experiences with the implementation of an integrated chronic care model at primary healthcare clinics in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100006&lng=pt&nrm=iso&tlng=pt BACKGROUND: An integrated chronic disease management model has been implemented across primary healthcare clinics in order to transform the delivery of services for patients with chronic diseases. The sustainability and rapid scale-up of the model is dependent on positive staff perceptions and experiences. OBJECTIVES: The aim of the study was to determine the perceptions and experiences of professional nurses with the integrated chronic care model that has been implemented. METHOD: A cross-sectional descriptive survey utilising a self-administered questionnaire was conducted amongst all professional nurses who were involved in delivering primary healthcare services at the 42 implementing facilities in September 2014. Each facility has between four and eight professional nurses providing a service daily at the facilities. RESULTS: A total of 264 professional nurses participated in the survey. Prior to the implementation, 34% (91) of the staff perceived the model to be an added programme, whilst 36% (96) of the staff experienced an increased workload. Staff noted an improved process of care, better level of interaction with patients, improved level of knowledge and better teamwork coupled with an improved level of satisfaction with the work environment at the clinic after implementation of the integrated chronic disease model. CONCLUSION: Professional nurses have a positive experience with the implementation of the integrated chronic disease management model. <![CDATA[<b>The role of emotional intelligence and organisational support on work stress of nurses in Ibadan, Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100007&lng=pt&nrm=iso&tlng=pt BACKGROUND: Universally, nurses have been reported to be a group at high risk of workplace stress. However, nurses' responses to stressful situations at work could be the outcomes of individual differences and organisational factors. OBJECTIVES: We examined the independent and joint contributions of four dimensions of emotional intelligence and perceived organisational support in work stress of nurses in a teaching hospital in Nigeria. METHODS: The study was a cross-sectional survey research design, which selected 228 (41 male and 187 female nurses) nurses through the use of convenience sampling. Questionnaires comprising demographics with work stress, organisational support and emotional intelligence scales were administered to the sampled 228 nurses in the study. Data were analysed with the use of correlational matrix and hierarchical multiple regression. RESULTS: Self-emotion appraisal, others' emotion appraisal, use of emotion, regulation of emotion and perceived organisational support were found to have joint contributions to explaining work stress among nurses. Others' emotion appraisal, use of emotion and perceived organisational support were found to have independent relationships with work stress. CONCLUSION: Our findings stress that judgement of others' emotions, accurate use of emotion by nurses and support from management of the hospital are most important in explaining their reactions towards work-related stress. <![CDATA[<b>Predictors of burnout among HIV nurses in the Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100008&lng=pt&nrm=iso&tlng=pt BACKGROUND: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients OBJECTIVE: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV. METHOD: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument - Nurse. RESULTS: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001). CONCLUSION: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work. <![CDATA[<b>Guidelines for support to mothers of sexually abused children in North-West province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100009&lng=pt&nrm=iso&tlng=pt BACKGROUND: South Africa is reported to have the highest rate of sexual assault in the world with over 40% of cases occurring among children. Children who are sexually abused have support programmes and policies to assist them in coping, but there are no support programmes for mothers or caretakers. Caretakers need support for themselves and assisting them will incrementally benefit children under their care. Often mothers of these children experience shock, anger, disbelief and suffer secondary trauma such as depression and post-traumatic stress disorder (PTSD) following their children's sexual abuse disclosure and yet there are no guidelines for support to these mothers within North-West province (NWP). OBJECTIVES: The study seeks to develop guidelines for support to mothers of sexually abused children in NWP. METHODS: Concurrent convergence triangulation mixed method design was employed in this study. The population consisted of mothers of sexually abused children (SAC) (n = 17 participants for the qualitative component and n = 180 participants for the quantitative component). A sample of mothers of SAC was purposely selected. RESULTS: The participants indicated significant levels of depression because of lack of support by stakeholders. Guidelines for support to assist mothers cope with their secondary trauma were developed based on the literature review, study findings as well as an ecological model of the impact of sexual assault on women's mental health. The results also showed extreme PTSD (47.8%), little support (38.8%), not coping (76.1%) and depression (36.1%) CONCLUSION: The stakeholders should consider a positive approach to support mothers whose children are sexually abused. <![CDATA[<b>The role of patient care workers in private hospitals in the Cape Metropole, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100010&lng=pt&nrm=iso&tlng=pt BACKGROUND: Nursing managers have to meet expectations of patients despite economic pressures, an increasing burden of disease and nursing shortages. Shifting health care-related tasks to lower categories of staff, including non-nursing support staff, has become one solution to address this dilemma. Patient care workers are a specific group of non-nursing support staff working in South African hospitals. Although patient care workers have been used for several years and their numbers are increasing, there are controversial opinions about the role of patient care workers, ranging from praise for their contribution towards patient care to serious concerns about the impact of their role on patient safety. OBJECTIVE: The study objective was to explore and describe the role of patient care workers in private hospitals. METHODS: A qualitative, descriptive design was applied to explore the role of patient care workers. Purposive sampling was used to select unit managers, nurses and patient care workers from medical and surgical wards of three private hospitals. Fifteen semi-structured interviews were conducted and transcribed verbatim. The researcher applied interpretative data analysis to move from the participants' descriptions of their experiences to a synthesis of all participants' descriptions. RESULTS: Patient care workers are involved in direct patient care and spend much time with patients, often not working under direct supervision of registered nurses despite limited training and lack of regulation. Their contribution, however, is valued by nurses. CONCLUSION: Patient care workers are well-integrated into the patient care team and are mostly seen as nurses. Yet, there are concerns about their evolving role despite their limited training and the lack of direct supervision. Regulating the work of patient care workers is recommended. <![CDATA[<b>Utilisation of the partogram among nurses and midwives in selected health facilities in the Eastern Province of Rwanda</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2223-62792017000100011&lng=pt&nrm=iso&tlng=pt BACKGROUND: Maternal mortality continues to be a global burden, with more than 200 million women becoming pregnant each year and a large number dying as a result of complications of pregnancy or childbirth. The World Health Organisation has recommended use of the partogram to monitor labour and delivery in order to improve healthcare and reduce maternal and foetal mortality rates. OBJECTIVE: This study described factors affecting utilisation of the partogram among nurses and midwives in selected health facilities of Rwanda. METHOD: A descriptive quantitative and cross-sectional research design was used. The population comprised 131 nurses and midwives providing obstetric care in 15 health institutions (1 hospital and 14 health centres). Data collection was through a self-administered questionnaire, and a pre-test of the data collection instrument was carried out to enhance validity and reliability. The Statistical Package for Social Sciences (version 21) was used to capture and analyse data. Ethical clearance was obtained from the University of the Western Cape (Republic of South Africa) and from the Institutional Review Board of Kigali Health Institute (Rwanda). Patricia Benner's model of nursing practice was used to guide the study. RESULTS: It was found that 36.6% of nurses and midwives did not receive any in-service training on how to manage women in labour. Despite fair knowledge of the partogram among nurses and midwives in this study, only 41.22% reported having used the partogram properly, while 58.78% reported not having done so. CONCLUSION: Nurses' and midwives' years of professional experience and training in managing pregnant women in labour were found to be predictors of the likelihood of proper use of the partogram. In-service training of obstetric caregivers in the Eastern Province of Rwanda is recommended to improve use of the partogram while managing women in labour.